Provider Demographics
NPI:1386892842
Name:PRIME SERVICE ENTERPRISE INC.
Entity type:Organization
Organization Name:PRIME SERVICE ENTERPRISE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEQUANENT
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERIHUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-499-2950
Mailing Address - Street 1:2361 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2977
Mailing Address - Country:US
Mailing Address - Phone:614-499-2950
Mailing Address - Fax:614-421-2323
Practice Address - Street 1:2361 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-2977
Practice Address - Country:US
Practice Address - Phone:614-499-2950
Practice Address - Fax:614-421-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRT484375344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi