Provider Demographics
NPI:1821671637
Name:VIP TRANSPORATION LLC
Entity Type:Organization
Organization Name:VIP TRANSPORATION LLC
Other - Org Name:VIP TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YAZIJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-716-1113
Mailing Address - Street 1:2550 E ROSE GARDEN LN UNIT 71187
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7708
Mailing Address - Country:US
Mailing Address - Phone:602-716-1113
Mailing Address - Fax:
Practice Address - Street 1:23217 NORTH 40TH WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:602-716-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)