Provider Demographics
NPI:1316429137
Name:VICTOR TRANSPORTATION LLC
Entity type:Organization
Organization Name:VICTOR TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENATOROVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-343-0363
Mailing Address - Street 1:22632 E RIDGE TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2698
Mailing Address - Country:US
Mailing Address - Phone:720-343-0363
Mailing Address - Fax:720-770-0267
Practice Address - Street 1:22632 E RIDGE TRAIL DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-2698
Practice Address - Country:US
Practice Address - Phone:720-343-0363
Practice Address - Fax:720-770-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)