MEDICARE: ASSURED RIDE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	342000000X	Transportation Network Company
2	343900000X	Non-emergency Medical Transport (VAN)
3	347C00000X	Private Vehicle
4	347E00000X	Transportation Broker
5	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1932899390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED RIDE LLC

Provider Business Mailing Address
First Line	:	3245 SIMPSON STUART RD APT 605
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-5034
Country	:	US
Telephone Number	:	469-704-6237
Fax Number	:

Provider Business Practice Location Address
First Line	:	9304 FOREST LN STE S146
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6238
Country	:	US
Telephone Number	:	469-704-6237
Fax Number	:

Authorized Official
Title or Position	:	OWNER / MANGER
Name	:	HENOK GIZAW
Credential	:
Telephone Number	:	469-704-6237

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	01/10/2024

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Directions to “ASSURED RIDE LLC ” Practice Location

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