Healthcare Provider Details

I. General information

NPI: 1891690996
Provider Name (Legal Business Name): HERIDE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 RIVERVIEW PL
JONESBORO GA
30238-2204
US

IV. Provider business mailing address

909 RIVERVIEW PL
JONESBORO GA
30238-2204
US

V. Phone/Fax

Practice location:
  • Phone: 706-296-1591
  • Fax:
Mailing address:
  • Phone: 706-296-1591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILLIAN ANDERSON
Title or Position: FOUNDER
Credential:
Phone: 706-296-1591