Provider Demographics
NPI:1134816788
Name:TD PREMIER ENTERPRISES LLC
Entity type:Organization
Organization Name:TD PREMIER ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORT
Authorized Official - Prefix:
Authorized Official - First Name:MARIER
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMS
Authorized Official - Suffix:
Authorized Official - Credentials:NEMT
Authorized Official - Phone:803-970-4218
Mailing Address - Street 1:201 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-1900
Mailing Address - Country:US
Mailing Address - Phone:803-970-4218
Mailing Address - Fax:
Practice Address - Street 1:201 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-1900
Practice Address - Country:US
Practice Address - Phone:803-970-4218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)