Provider Demographics
NPI:1750861720
Name:PREMIER ELITE TRANSPORTATION
Entity Type:Organization
Organization Name:PREMIER ELITE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KANDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:KINDER-COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:904-318-3540
Mailing Address - Street 1:PO BOX 9132
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-0132
Mailing Address - Country:US
Mailing Address - Phone:904-318-3540
Mailing Address - Fax:
Practice Address - Street 1:6130 ALPENROSE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1658
Practice Address - Country:US
Practice Address - Phone:904-329-2586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-18
Last Update Date:2018-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)