Provider Demographics
NPI:1669115689
Name:PEAK ENTERPRISE, LLC
Entity type:Organization
Organization Name:PEAK ENTERPRISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MEYNARD
Authorized Official - Middle Name:MORALES
Authorized Official - Last Name:MARCOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-295-0150
Mailing Address - Street 1:793 E. FOOTHILL BLVD
Mailing Address - Street 2:SUITE A, #53
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405
Mailing Address - Country:US
Mailing Address - Phone:805-295-0150
Mailing Address - Fax:805-623-4186
Practice Address - Street 1:1567 FRAMBUESA DR
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-4746
Practice Address - Country:US
Practice Address - Phone:805-295-0150
Practice Address - Fax:805-623-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)