Healthcare Provider Details

I. General information

NPI: 1023509494
Provider Name (Legal Business Name): MEDIRIDES TRANSPORTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SE OSCEOLA AVE STE 4
OCALA FL
34471-2171
US

IV. Provider business mailing address

303 SE OSCEOLA AVE STE 4
OCALA FL
34471-2171
US

V. Phone/Fax

Practice location:
  • Phone: 352-619-7371
  • Fax: 800-571-3118
Mailing address:
  • Phone: 352-619-7371
  • Fax: 800-571-3118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: K SPELLMAN
Title or Position: COO
Credential:
Phone: 352-619-7371