Provider Demographics
NPI:1003208265
Name:VIA MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:VIA MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTEO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPAOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-892-5266
Mailing Address - Street 1:16 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-4315
Mailing Address - Country:US
Mailing Address - Phone:609-892-5266
Mailing Address - Fax:609-704-5719
Practice Address - Street 1:301 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1161
Practice Address - Country:US
Practice Address - Phone:609-704-5909
Practice Address - Fax:609-704-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)