MEDICARE: VITAL RIDES LLC

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1710773031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL RIDES LLC

Provider Business Mailing Address
First Line	:	3315 W CAPOVILLA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-5218
Country	:	US
Telephone Number	:	702-984-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3315 W CAPOVILLA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-5218
Country	:	US
Telephone Number	:	702-984-4700
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MARILYN JONES
Credential	:
Telephone Number	:	702-984-4700

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	04/15/2025

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Directions to “VITAL RIDES LLC ” Practice Location

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