Healthcare Provider Details

I. General information

NPI: 1134800303
Provider Name (Legal Business Name): FREE RIDE FOX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 57TH ST STE 556
SACRAMENTO CA
95819-3327
US

IV. Provider business mailing address

836 57TH ST STE 556
SACRAMENTO CA
95819-3327
US

V. Phone/Fax

Practice location:
  • Phone: 916-891-4451
  • Fax: 916-891-4394
Mailing address:
  • Phone: 916-891-4451
  • Fax: 916-891-4394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MS. MOLLY MURPHY
Title or Position: MEMBER-MANAGER
Credential:
Phone: 916-891-4451