MEDICARE: GO RIDE SHREVEPORT

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	:	1407704315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO RIDE SHREVEPORT

Provider Business Mailing Address
First Line	:	124 HEYMANN BLVD STE 107
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2363
Country	:	US
Telephone Number	:	225-367-4065
Fax Number	:

Provider Business Practice Location Address
First Line	:	3218 LINE AVE STE 120
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-4255
Country	:	US
Telephone Number	:	225-367-4065
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & MANAGING MEMBER
Name	:	DAN REID
Credential	:
Telephone Number	:	601-544-5403

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “GO RIDE SHREVEPORT ” Practice Location

Language	Start Address	Practice Location

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