MEDICARE: VIP & ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1629598818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIP & ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 26191
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23260-6191
Country	:	US
Telephone Number	:	804-421-2500
Fax Number	:	804-329-5050

Provider Business Practice Location Address
First Line	:	3915 CORBIN ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-1111
Country	:	US
Telephone Number	:	804-421-2500
Fax Number	:	804-329-5050

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MR. THEYDON H. GREEN
Credential	:
Telephone Number	:	804-421-2500

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	06/20/2017

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Directions to “VIP & ASSOCIATES, INC. ” Practice Location

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