Provider Demographics
NPI:1356704084
Name:PREMIER TRANSPORTATION SERVICES, LLC
Entity type:Organization
Organization Name:PREMIER TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-422-7728
Mailing Address - Street 1:3105 LINDA ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71119
Mailing Address - Country:US
Mailing Address - Phone:318-422-7728
Mailing Address - Fax:
Practice Address - Street 1:3105 LINDA ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71119-5212
Practice Address - Country:US
Practice Address - Phone:318-422-7728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)