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NPI Code Detail

MEDICARE: PROSPERITY EMS, LLC

MEDICARE: PROSPERITY EMS, 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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1245079854
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROSPERITY EMS, LLC
Provider Business Mailing Address
First Line : 8801 FAST PARK DR STE 301-1051
Second Line :
City : RALEIGH
State : NC
Zip : 27617-4852
Country : US
Telephone Number : 919-438-1853
Fax Number :
Provider Business Practice Location Address
First Line : 8801 FAST PARK DR STE 301-1051
Second Line :
City : RALEIGH
State : NC
Zip : 27617-4852
Country : US
Telephone Number : 919-438-1853
Fax Number :
Authorized Official
Title or Position : CEO
Name : AMANDA LEMON
Credential :
Telephone Number : 919-438-1853
Provider Enumeration Date : 05/22/2024
Last Update Date : 05/22/2024

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Directions to “PROSPERITY EMS, LLC ” Practice Location

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