Provider Demographics
NPI:1326861923
Name:VITAL MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:VITAL MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-712-3334
Mailing Address - Street 1:1881 E MCNAIR DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-4279
Mailing Address - Country:US
Mailing Address - Phone:216-310-0207
Mailing Address - Fax:
Practice Address - Street 1:4700 S MILL AVE # B5
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6736
Practice Address - Country:US
Practice Address - Phone:480-712-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)