Provider Demographics
NPI:1760022552
Name:PRIME TRANSPORT SERVICES INC
Entity Type:Organization
Organization Name:PRIME TRANSPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSHEN
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-823-6699
Mailing Address - Street 1:2288 GUNBARREL RD STE 154
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3492
Mailing Address - Country:US
Mailing Address - Phone:770-823-6699
Mailing Address - Fax:
Practice Address - Street 1:7468 ALLEMANDE WAY APT 208
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3032
Practice Address - Country:US
Practice Address - Phone:770-823-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)