Organization
PREMIER EXPRESS TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEDRA JACKSON (CEO)
(440) 941-3763
Entity
Organization
Contact information
Practice address
782 E 130TH ST, CLEVELAND, OH 44108-2544
(440) 941-3763
Mailing address
782 E 130TH ST, CLEVELAND, OH 44108-2544
(440) 941-3763
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
344600000X
Taxi
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
05/02/2022
Last updated
05/04/2022
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