Provider Demographics
NPI:1912463647
Name:MIKE'S VIP TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:MIKE'S VIP TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-699-4322
Mailing Address - Street 1:8652 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1441
Mailing Address - Country:US
Mailing Address - Phone:718-699-4322
Mailing Address - Fax:
Practice Address - Street 1:8652 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-1441
Practice Address - Country:US
Practice Address - Phone:718-699-4322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)