Provider Demographics
NPI:1649890294
Name:PRECIOUS LIFE TRANSPORTATION LLC
Entity type:Organization
Organization Name:PRECIOUS LIFE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAMELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON-NORFLEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-743-3758
Mailing Address - Street 1:2788A COVENTRY GRN SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2163
Mailing Address - Country:US
Mailing Address - Phone:833-743-3758
Mailing Address - Fax:
Practice Address - Street 1:2788A COVENTRY GRN SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2163
Practice Address - Country:US
Practice Address - Phone:833-743-3758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)