1053875591 NPI number — PREZTIGE MEDICAL TRANSPORTATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053875591 NPI number — PREZTIGE MEDICAL TRANSPORTATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREZTIGE MEDICAL TRANSPORTATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053875591
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43656 VINTAGE OAKS DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STERLING HEIGHTS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-744-8444
Provider Business Mailing Address Fax Number:
313-264-1497

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43656 VINTAGE OAKS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STERLING HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-744-8444
Provider Business Practice Location Address Fax Number:
313-264-1497
Provider Enumeration Date:
01/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
WILLINGHAM
Authorized Official First Name:
ARLANZZIA
Authorized Official Middle Name:
CHANISH
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
586-744-5444

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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