Healthcare Provider Details

I. General information

NPI: 1346089273
Provider Name (Legal Business Name): MIBUDDYRIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N 20TH ST
BATTLE CREEK MI
49015-1746
US

IV. Provider business mailing address

105 N 20TH ST
BATTLE CREEK MI
49015-1746
US

V. Phone/Fax

Practice location:
  • Phone: 269-719-2501
  • Fax:
Mailing address:
  • Phone: 269-719-2501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: KEVIN HEDRINGTON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 269-719-2501