Provider Demographics
NPI:1295321404
Name:RUNNER V.I.P. LLC
Entity type:Organization
Organization Name:RUNNER V.I.P. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-821-7194
Mailing Address - Street 1:PO BOX 5366
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-0366
Mailing Address - Country:US
Mailing Address - Phone:215-821-7194
Mailing Address - Fax:
Practice Address - Street 1:1205 E CHELTEN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-1928
Practice Address - Country:US
Practice Address - Phone:267-236-9357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)