Provider Demographics
NPI:1235490566
Name:PREMIER MEDICAL TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:PREMIER MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:TODORA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-662-5077
Mailing Address - Street 1:1004 VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5454
Mailing Address - Country:US
Mailing Address - Phone:985-662-5077
Mailing Address - Fax:985-662-0743
Practice Address - Street 1:1004 VENICE AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5454
Practice Address - Country:US
Practice Address - Phone:985-662-5077
Practice Address - Fax:985-662-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)