Healthcare Provider Details

I. General information

NPI: 1407298847
Provider Name (Legal Business Name): RIDE RITE MEDI VAN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 STATE RD E
WESTMINSTER MA
01473-1230
US

IV. Provider business mailing address

160 STATE RD E
WESTMINSTER MA
01473-1230
US

V. Phone/Fax

Practice location:
  • Phone: 978-668-5122
  • Fax: 978-668-5154
Mailing address:
  • Phone: 978-668-5122
  • Fax: 978-668-5154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number00000000
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number000000000
License Number StateMA

VIII. Authorized Official

Name: NICCO CICCOLINI
Title or Position: MANAGER
Credential:
Phone: 978-668-5122