Provider Demographics
NPI:1255103891
Name:PREMIER TRANSPORTATION, LLC
Entity type:Organization
Organization Name:PREMIER TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER/MANGER
Authorized Official - Prefix:
Authorized Official - First Name:ERICQUANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-220-5292
Mailing Address - Street 1:3109 HIGH MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0035
Mailing Address - Country:US
Mailing Address - Phone:254-220-5292
Mailing Address - Fax:
Practice Address - Street 1:3109 HIGH MEADOW ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-0035
Practice Address - Country:US
Practice Address - Phone:254-220-5292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)