Healthcare Provider Details

I. General information

NPI: 1285815290
Provider Name (Legal Business Name): RIDE-N-OUR ELEVATOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6554 44TH ST. NO. 1010
PINELLAS PARK FL
33781-5963
US

IV. Provider business mailing address

6554 44TH ST. NO. 1010
PINELLAS PARK FL
33781-5963
US

V. Phone/Fax

Practice location:
  • Phone: 727-526-3585
  • Fax:
Mailing address:
  • Phone: 727-526-3585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberCC2294
License Number StateFL

VIII. Authorized Official

Name: MR. JOHN R. PERRONI
Title or Position: GENERAL MANAGER
Credential: N/A
Phone: 727-526-3585