Provider Demographics
NPI:1760605836
Name:PREMIER JETS INC
Entity Type:Organization
Organization Name:PREMIER JETS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RENHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-640-2927
Mailing Address - Street 1:PO BOX 928
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-0928
Mailing Address - Country:US
Mailing Address - Phone:503-640-2927
Mailing Address - Fax:503-681-3064
Practice Address - Street 1:2140 NE 25TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5962
Practice Address - Country:US
Practice Address - Phone:503-640-2927
Practice Address - Fax:503-681-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR34063416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR120154OtherKAISER PERMANENTE
ORR000RCGMWMedicaid
OR0000RGCMWMedicaid
OR52176701Medicare UPIN