Healthcare Provider Details

I. General information

NPI: 1629598818
Provider Name (Legal Business Name): VIP & ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 CORBIN ST
RICHMOND VA
23222-1111
US

IV. Provider business mailing address

PO BOX 26191
RICHMOND VA
23260-6191
US

V. Phone/Fax

Practice location:
  • Phone: 804-421-2500
  • Fax: 804-329-5050
Mailing address:
  • Phone: 804-421-2500
  • Fax: 804-329-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. THEYDON H. GREEN
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 804-421-2500