Healthcare Provider Details

I. General information

NPI: 1598325599
Provider Name (Legal Business Name): RIDE WITH US MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 09/29/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3877 C. ROGERS RD
GAINESVILLE GA
30506
US

IV. Provider business mailing address

3877 C. ROGERS RD
GAINESVILLE GA
30506
US

V. Phone/Fax

Practice location:
  • Phone: 678-313-5193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DARLENE UNDERWOOD
Title or Position: OWNER
Credential:
Phone: 678-313-5193