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General NPI Number Information
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NPI Number | 1326861923
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Entity Type | Organization
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Legal Business Name | VITAL MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 4700 S MILL AVE # B5
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City | TEMPE
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State | AZ
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Zip | 85282-6736
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Country | US
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Telephone | 480-712-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 1881 E MCNAIR DR
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City | TEMPE
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State | AZ
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Zip | 85283-4279
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Country | US
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Telephone | 216-310-0207
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Fax |
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | MS. BRANDY DANIELLE ALEXANDER
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Credential | NP
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Telephone | 480-712-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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