MEDICARE: FREE RIDE LLC

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1326748260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREE RIDE LLC

Provider Business Mailing Address
First Line	:	902 SAHWATCH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4204
Country	:	US
Telephone Number	:	719-272-1916
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 SAHWATCH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4204
Country	:	US
Telephone Number	:	719-272-1916
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JASON JENKINS
Credential	:
Telephone Number	:	719-272-1916

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	03/08/2023

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Directions to “FREE RIDE LLC ” Practice Location

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