Provider Demographics
NPI:1346733524
Name:PRIORITY TRANSPORT LLC
Entity Type:Organization
Organization Name:PRIORITY TRANSPORT LLC
Other - Org Name:PRIORITY TRANSPORT LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:N
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-894-1516
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23875-0500
Mailing Address - Country:US
Mailing Address - Phone:804-894-1516
Mailing Address - Fax:
Practice Address - Street 1:4320 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-3337
Practice Address - Country:US
Practice Address - Phone:804-894-1516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA227473794Medicaid
VA227473794Medicaid