Provider Demographics
NPI:1497509434
Name:PRIME FOUNDATION LLC
Entity type:Organization
Organization Name:PRIME FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRUDENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:183-289-9945
Mailing Address - Street 1:6319 VIRGINIA FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0328
Mailing Address - Country:US
Mailing Address - Phone:183-289-9945
Mailing Address - Fax:
Practice Address - Street 1:6319 VIRGINIA FIELDS DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0328
Practice Address - Country:US
Practice Address - Phone:183-289-9945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)