Provider Demographics
NPI:1790438109
Name:CM PRESABOELZ LLC
Entity Type:Organization
Organization Name:CM PRESABOELZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CONTRAZE
Authorized Official - Middle Name:LORANT
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-709-3492
Mailing Address - Street 1:2196 NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-7371
Mailing Address - Country:US
Mailing Address - Phone:910-709-3492
Mailing Address - Fax:
Practice Address - Street 1:2196 NEVADA ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-7371
Practice Address - Country:US
Practice Address - Phone:910-709-3492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)