Provider Demographics
NPI:1669019196
Name:VICTORY TRANSPORTS INC
Entity Type:Organization
Organization Name:VICTORY TRANSPORTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-880-1410
Mailing Address - Street 1:PO BOX 533
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:VA
Mailing Address - Zip Code:24280-0533
Mailing Address - Country:US
Mailing Address - Phone:276-880-1410
Mailing Address - Fax:
Practice Address - Street 1:169 KNOBS LN
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609-8279
Practice Address - Country:US
Practice Address - Phone:276-880-1410
Practice Address - Fax:276-880-2079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)