Provider Demographics
NPI:1689107120
Name:PRIME TRANSIT, LLC
Entity Type:Organization
Organization Name:PRIME TRANSIT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIPPS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:504-957-5062
Mailing Address - Street 1:PO BOX 58617
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70158-8617
Mailing Address - Country:US
Mailing Address - Phone:337-426-0821
Mailing Address - Fax:
Practice Address - Street 1:27 KRISTEN CT
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-1171
Practice Address - Country:US
Practice Address - Phone:337-426-0821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7954343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA020229107OtherDEPT OF CHILDREN FAMILIES SERVICES