Provider Demographics
NPI:1073812905
Name:VIP TRANSPORTATION SERVICES, INC.
Entity Type:Organization
Organization Name:VIP TRANSPORTATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAOUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-966-9500
Mailing Address - Street 1:1450 HADDON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-3121
Mailing Address - Country:US
Mailing Address - Phone:856-966-9500
Mailing Address - Fax:856-966-9800
Practice Address - Street 1:1450 HADDON AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-3121
Practice Address - Country:US
Practice Address - Phone:856-966-9500
Practice Address - Fax:856-966-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJVIPT00617Medicaid
NJ01000275100OtherAMERICHOICE
NJ89926OtherAMERIGROUP
NJ1140891OtherHORIZON NJ HEALTH