Healthcare Provider Details

I. General information

NPI: 1356181663
Provider Name (Legal Business Name): CARERIDE SHUTTLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 05/27/2024
Certification Date: 05/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5272 LYONS CIR S
WARREN MI
48092-1721
US

IV. Provider business mailing address

5272 LYONS CIR S
WARREN MI
48092-1721
US

V. Phone/Fax

Practice location:
  • Phone: 475-319-8253
  • Fax:
Mailing address:
  • Phone: 475-319-8253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: TAKI KHAN
Title or Position: OWNER
Credential:
Phone: 475-319-8253