Healthcare Provider Details

I. General information

NPI: 1356245898
Provider Name (Legal Business Name): T-RIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 BOYD ST
OMAHA NE
68104-5248
US

IV. Provider business mailing address

4850 BOYD ST
OMAHA NE
68104-5248
US

V. Phone/Fax

Practice location:
  • Phone: 402-612-6588
  • Fax:
Mailing address:
  • Phone: 402-612-6588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KOFFIVI GAGLO
Title or Position: CEO
Credential:
Phone: 402-612-6588