Provider Demographics
NPI:1124322532
Name:VITAL TRANSPORT LLC
Entity type:Organization
Organization Name:VITAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORELLANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-948-7879
Mailing Address - Street 1:2560 CATAMARAN WAY
Mailing Address - Street 2:SUITE 11
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4533
Mailing Address - Country:US
Mailing Address - Phone:619-259-2442
Mailing Address - Fax:619-259-2999
Practice Address - Street 1:2560 CATAMARAN WAY
Practice Address - Street 2:SUITE 11
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4533
Practice Address - Country:US
Practice Address - Phone:619-259-2442
Practice Address - Fax:619-259-2999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)