Provider Demographics
NPI: | 1013421460 |
---|---|
Name: | NEW VISION TRANSPORTATION LLC |
Entity Type: | Organization |
Organization Name: | NEW VISION TRANSPORTATION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JORGE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | VASQUEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 703-888-9888 |
Mailing Address - Street 1: | 13509 CHIPPER CT |
Mailing Address - Street 2: | |
Mailing Address - City: | GAINESVILLE |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 20155-6003 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 703-888-9888 |
Mailing Address - Fax: | 703-753-2900 |
Practice Address - Street 1: | 13509 CHIPPER CT |
Practice Address - Street 2: | |
Practice Address - City: | GAINESVILLE |
Practice Address - State: | VA |
Practice Address - Zip Code: | 20155-6003 |
Practice Address - Country: | US |
Practice Address - Phone: | 703-888-9888 |
Practice Address - Fax: | 703-753-2900 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-11-21 |
Last Update Date: | 2017-11-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 10719122-2017 | 343900000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |