Provider Demographics
NPI:1922553916
Name:VIP EXPRESS TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:VIP EXPRESS TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BRAICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-668-5899
Mailing Address - Street 1:27775 AVENIDA QUINTANA
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-8416
Mailing Address - Country:US
Mailing Address - Phone:760-322-2224
Mailing Address - Fax:888-492-8288
Practice Address - Street 1:27775 AVENIDA QUINTANA
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-8416
Practice Address - Country:US
Practice Address - Phone:760-322-2224
Practice Address - Fax:888-492-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCP-26829-B343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)