Healthcare Provider Details

I. General information

NPI: 1538021365
Provider Name (Legal Business Name): RIDON TRANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S SECOND ST STE 3
GALLUP NM
87301-5898
US

IV. Provider business mailing address

1500 S SECOND ST STE 3
GALLUP NM
87301-5898
US

V. Phone/Fax

Practice location:
  • Phone: 888-920-8883
  • Fax: 505-657-7527
Mailing address:
  • Phone: 888-920-8883
  • Fax: 505-657-7527

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: MOHAMED ABDELAZIM
Title or Position: CEO
Credential:
Phone: 602-800-4022