Provider Demographics
NPI:1992563670
Name:PRESTIGE TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:PRESTIGE TRANSPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KEDRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-737-4409
Mailing Address - Street 1:2006 PHILLIPS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5953
Mailing Address - Country:US
Mailing Address - Phone:919-737-4409
Mailing Address - Fax:
Practice Address - Street 1:2006 PHILLIPS AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5953
Practice Address - Country:US
Practice Address - Phone:919-737-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)