Provider Demographics
NPI:1366776254
Name:PRIME TIME TRANSPORTATION, INC.
Entity type:Organization
Organization Name:PRIME TIME TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-482-7970
Mailing Address - Street 1:2320 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4313
Mailing Address - Country:US
Mailing Address - Phone:718-482-7970
Mailing Address - Fax:718-482-6997
Practice Address - Street 1:2320 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4313
Practice Address - Country:US
Practice Address - Phone:718-482-7970
Practice Address - Fax:718-482-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343800000X, 343900000X, 347B00000X, 347C00000X
347B00000X
NYB00296347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus