Healthcare Provider Details

I. General information

NPI: 1922931773
Provider Name (Legal Business Name): RIVERSIDE RIDESHARE SERVICE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 CHRISTOPHER DR
RUSSELL SPRINGS KY
42642
US

IV. Provider business mailing address

PO BOX 184
RUSSELL SPRINGS KY
42642-0184
US

V. Phone/Fax

Practice location:
  • Phone: 859-398-1439
  • Fax:
Mailing address:
  • Phone: 270-283-9325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347D00000X
TaxonomyTrain
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: RIVERSIDE RIDESHARE SERVICE LLC
Title or Position: FOUNDER
Credential:
Phone: 270-283-9325