Provider Demographics
NPI:1659039568
Name:PREVAIL MEDICAL TRANSPORTATION COMPANY, LLC
Entity type:Organization
Organization Name:PREVAIL MEDICAL TRANSPORTATION COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHAMBRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-389-3936
Mailing Address - Street 1:PO BOX 1862
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63302-1862
Mailing Address - Country:US
Mailing Address - Phone:636-389-3936
Mailing Address - Fax:
Practice Address - Street 1:1802 WOODRIDGE LN
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-1912
Practice Address - Country:US
Practice Address - Phone:314-203-8618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)