Provider Demographics
NPI:1154802189
Name:PRIME MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:PRIME MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:757-869-4237
Mailing Address - Street 1:2011 SARAHS COVE DR
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-3746
Mailing Address - Country:US
Mailing Address - Phone:757-869-4237
Mailing Address - Fax:
Practice Address - Street 1:2011 SARAHS COVE DR
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3746
Practice Address - Country:US
Practice Address - Phone:757-869-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA53206343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)