MEDICARE: ACE RIDE SHARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1164050738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE RIDE SHARE

Provider Business Mailing Address
First Line	:	5725 E LANCASTER AVE # 209
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-6528
Country	:	US
Telephone Number	:	817-851-1663
Fax Number	:

Provider Business Practice Location Address
First Line	:	5725 E LANCASTER AVE # 209
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-6528
Country	:	US
Telephone Number	:	817-851-1663
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JABRILL JIMAALE
Credential	:
Telephone Number	:	612-221-8999

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	11/13/2023

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Directions to “ACE RIDE SHARE ” Practice Location

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