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General NPI Number Information
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NPI Number | 1770443152
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Entity Type | Organization
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Legal Business Name | PRIME WHEELS LLC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 4620 US HIGHWAY 377 S UNIT 2B
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City | KRUGERVILLE
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State | TX
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Zip | 76227-6803
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Country | US
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Telephone | 940-281-6553
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Fax | 940-281-6553
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Provider Business Mailing Address
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Address Line | 612 OGLETHORPE LN
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City | SAVANNAH
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State | TX
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Zip | 76227-7970
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Country | US
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Telephone | 940-281-6553
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Fax | 940-281-6553
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Authorized Official
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Title or Position | CEO
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Name | MARTINEZ WALLACE
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Credential |
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Telephone | 940-281-6553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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