Provider Demographics
NPI:1144754565
Name:PRESTIGE MEDICAL TRANSPORTATION INC.
Entity type:Organization
Organization Name:PRESTIGE MEDICAL TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANTZ
Authorized Official - Middle Name:F
Authorized Official - Last Name:MORENCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-924-0167
Mailing Address - Street 1:6659 PEACHTREE INDUSTRIAL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4300
Mailing Address - Country:US
Mailing Address - Phone:404-924-0167
Mailing Address - Fax:
Practice Address - Street 1:6659 PEACHTREE INDUSTRIAL BLVD STE C
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4300
Practice Address - Country:US
Practice Address - Phone:404-924-0167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050834707343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)