Provider Demographics
NPI:1770443152
Name:PRIME WHEELS LLC
Entity type:Organization
Organization Name:PRIME WHEELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTINEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-281-6553
Mailing Address - Street 1:612 OGLETHORPE LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TX
Mailing Address - Zip Code:76227-7970
Mailing Address - Country:US
Mailing Address - Phone:940-281-6553
Mailing Address - Fax:940-281-6553
Practice Address - Street 1:4620 US HIGHWAY 377 S UNIT 2B
Practice Address - Street 2:
Practice Address - City:KRUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:76227-6803
Practice Address - Country:US
Practice Address - Phone:940-281-6553
Practice Address - Fax:940-281-6553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)