Victory Medical Transportation, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VICTORY MEDICAL TRANSPORTATION, INC.

Practice address

3604 S Banner St Ste 102
Boise, ID 83709-4316

Phone

(208) 401-1400

Fax

(208) 401-1401

NPI assigned

Oct 10, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tangina Maloof

Title

Treasurer

Phone

(469) 636-5055

Specialties & licenses 5

Addresses

Other names 1

• Victory EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Victory EMS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Victory Medical Transportation

  • Non-emergency Medical Transport (VAN)
  • Boise, ID
  • NPI 1326499419
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1770058265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29222 RANCHO VIEJO RD STE 127",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751049",
            "telephone_number": "949-426-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 S BANNER ST STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837094316",
            "telephone_number": "208-401-1400",
            "fax_number": "208-401-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL TRANSPORTATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "MALOOF",
        "authorized_official_first_name": "TANGINA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "469-636-5055"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416A0800X",
            "taxonomy_group": "",
            "desc": "Ambulance, Air Transport",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Victory EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber M Vickers, PA-C
• Jenny Vickhammer, BCBA
• Cymbria Arielynn Victor
• Devon Victorine
• Victory Medical Transportation
• Victory Surgical Services PLLC
• Elizabeth Anne Videen, LPC
• Laura Breanna Videtich, DDS
• Cristina Maria Vieira, CSWA
• Nicholas John Vietri, M.D.

• Land Ambulance in Boise, ID
• Providers in Boise, ID by specialty
• Land Ambulance in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.