Provider Demographics
NPI:1366965667
Name:3 VEST MEDICAL TRANSPORTATION WC LLC
Entity type:Organization
Organization Name:3 VEST MEDICAL TRANSPORTATION WC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:951-314-4380
Mailing Address - Street 1:3256 RURAL LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-8378
Mailing Address - Country:US
Mailing Address - Phone:951-314-4380
Mailing Address - Fax:951-547-0019
Practice Address - Street 1:3256 RURAL LANE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882
Practice Address - Country:US
Practice Address - Phone:951-314-4380
Practice Address - Fax:951-547-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherIRS