Provider Demographics
NPI:1720582042
Name:VIDA NON-EMERGENCY TRANSPORTATION SERVICES INC.
Entity Type:Organization
Organization Name:VIDA NON-EMERGENCY TRANSPORTATION SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO (OWNER)
Authorized Official - Prefix:
Authorized Official - First Name:ELISEO
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADO-LUPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-769-6546
Mailing Address - Street 1:1472 CLOVERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-4069
Mailing Address - Country:US
Mailing Address - Phone:209-769-2982
Mailing Address - Fax:
Practice Address - Street 1:1180 W OLIVE AVE STE K-1
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1900
Practice Address - Country:US
Practice Address - Phone:209-769-2982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)