Provider Demographics
NPI:1316125875
Name:P C B TRANSPORT
Entity type:Organization
Organization Name:P C B TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PRINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:407-201-5399
Mailing Address - Street 1:4220 BIG VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3211
Mailing Address - Country:US
Mailing Address - Phone:407-201-5399
Mailing Address - Fax:407-201-5399
Practice Address - Street 1:4220 BIG VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3211
Practice Address - Country:US
Practice Address - Phone:407-201-5399
Practice Address - Fax:407-201-5399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A DIRECT AUTO SERVICE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL-01343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)