Provider Demographics
NPI:1063952984
Name:PREMIER TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:PREMIER TRANSPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAMARELANBIA
Authorized Official - Suffix:
Authorized Official - Credentials:10/25/1977
Authorized Official - Phone:520-440-8051
Mailing Address - Street 1:2302 E SPEEDWAY BLVD
Mailing Address - Street 2:STE # 104
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-4742
Mailing Address - Country:US
Mailing Address - Phone:520-991-2319
Mailing Address - Fax:520-207-4830
Practice Address - Street 1:2302 E SPEEDWAY BLVD
Practice Address - Street 2:STE # 104
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4742
Practice Address - Country:US
Practice Address - Phone:520-991-2319
Practice Address - Fax:520-207-4830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)