Healthcare Provider Details

I. General information

NPI: 1851517809
Provider Name (Legal Business Name): RIDE-AWAY HANDICAP EQUIPMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 WENTWORTH AVE
LONDONDERRY NH
03053-7475
US

IV. Provider business mailing address

54 WENTWORTH AVE
LONDONDERRY NH
03053-7475
US

V. Phone/Fax

Practice location:
  • Phone: 603-437-4444
  • Fax: 603-432-3249
Mailing address:
  • Phone: 603-437-4444
  • Fax: 603-432-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0021413429
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNH

VIII. Authorized Official

Name: MR. MARK LORE
Title or Position: OWNER
Credential:
Phone: 800-237-7979