Provider Demographics
NPI:1962542233
Name:PRIORITY PATIENT TRANSPORT INC
Entity type:Organization
Organization Name:PRIORITY PATIENT TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-313-1919
Mailing Address - Street 1:49 LOG HOMES DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3947
Mailing Address - Country:US
Mailing Address - Phone:540-438-7741
Mailing Address - Fax:
Practice Address - Street 1:49 LOG HOMES DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3947
Practice Address - Country:US
Practice Address - Phone:540-438-7741
Practice Address - Fax:540-438-7743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1262341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance