Provider Demographics
NPI:1619320470
Name:HELPING VANS WEST LLC
Entity Type:Organization
Organization Name:HELPING VANS WEST LLC
Other - Org Name:HELPING VANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:IRISH-MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:BA ACCOUNTANCY
Authorized Official - Phone:509-780-7117
Mailing Address - Street 1:13284 WILLIS RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-7790
Mailing Address - Country:US
Mailing Address - Phone:208-577-0876
Mailing Address - Fax:
Practice Address - Street 1:13284 WILLIS RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83607-7790
Practice Address - Country:US
Practice Address - Phone:208-577-0876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi