Provider Demographics
NPI:1447761697
Name:PREMIER TRANSPORT LLC
Entity Type:Organization
Organization Name:PREMIER TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:MARKEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-609-1451
Mailing Address - Street 1:12787 B.T.W. HWY
Mailing Address - Street 2:SUITE 104 #245
Mailing Address - City:HARDY
Mailing Address - State:VA
Mailing Address - Zip Code:24101
Mailing Address - Country:US
Mailing Address - Phone:434-609-1457
Mailing Address - Fax:
Practice Address - Street 1:12787 B.T.W. HWY
Practice Address - Street 2:SUITE 104 #245
Practice Address - City:HARDY
Practice Address - State:VA
Practice Address - Zip Code:24101
Practice Address - Country:US
Practice Address - Phone:434-609-1457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)