Provider Demographics
NPI:1205511698
Name:PREMIUM MOVING SERVICES LLC
Entity type:Organization
Organization Name:PREMIUM MOVING SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:SACKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-757-5135
Mailing Address - Street 1:949 SCHALLER DR S
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7652 215TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-8984
Practice Address - Country:US
Practice Address - Phone:651-461-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No347E00000XTransportation ServicesTransportation Broker