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General NPI Number Information
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NPI Number | 1679393490
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Entity Type | Organization
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Legal Business Name | VITAL RIDE SERVICES LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 8427 HUNTERS FORK LOOP
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City | RUSKIN
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State | FL
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Zip | 33573-0159
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Country | US
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Telephone | 813-679-3094
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Fax |
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Provider Business Mailing Address
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Address Line | 8427 HUNTERS FORK LOOP
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City | RUSKIN
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State | FL
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Zip | 33573-0159
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Country | US
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Telephone | 813-679-3094
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Fax |
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Authorized Official
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Title or Position | AP
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Name | MR. HAROLD MARVIN VITAL-HERNE
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Credential |
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Telephone | 813-679-3094
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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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