MEDICARE: PRINCE TRANSPORT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1093689473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCE TRANSPORT LLC

Provider Business Mailing Address
First Line	:	10224 GHOST GUM ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7330
Country	:	US
Telephone Number	:	702-628-2497
Fax Number	:

Provider Business Practice Location Address
First Line	:	10224 GHOST GUM ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7330
Country	:	US
Telephone Number	:	702-628-2497
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CATHERINE PRINCIPE
Credential	:
Telephone Number	:	702-628-2497

Provider Enumeration Date	:	09/30/2025
Last Update Date	:	09/30/2025

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