Provider Demographics
NPI:1356149348
Name:PRIORITY MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:PRIORITY MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABU HURAIRA
Authorized Official - Middle Name:MAHMOOD
Authorized Official - Last Name:RAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-290-1639
Mailing Address - Street 1:16059 CROSSED TALONS RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5891
Mailing Address - Country:US
Mailing Address - Phone:571-290-1639
Mailing Address - Fax:
Practice Address - Street 1:16059 CROSSED TALONS RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5891
Practice Address - Country:US
Practice Address - Phone:571-290-1639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)