Organization
VICTORY ROYAL EXPRESS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHEBE GUTIERREZ (TRANSPORTATION DIRECTOR)
(505) 425-5170
Entity
Organization
Contact information
Practice address
2810 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-4119
(505) 425-5170
(505) 425-5175
Mailing address
PO BOX 670, LAS VEGAS, NM 87701-0670
(505) 425-5170
(505) 425-5175
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q3409
—
NM
Enumeration date
01/25/2007
Last updated
08/22/2020
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