MEDICARE: FRIENDLY RIDE

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)	954519	OH

General Provider Information

NPI Number	:	1790833440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY RIDE

Provider Business Mailing Address
First Line	:	2490 LEE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-4125
Country	:	US
Telephone Number	:	216-321-5705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2490 LEE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-4125
Country	:	US
Telephone Number	:	216-321-5705
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BABATUNDE MOSHOOD
Credential	:
Telephone Number	:	216-321-5705

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	08/22/2020

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