Healthcare Provider Details

I. General information

NPI: 1790833440
Provider Name (Legal Business Name): FRIENDLY RIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 LEE RD
CLEVELAND OH
44118-4125
US

IV. Provider business mailing address

2490 LEE RD
CLEVELAND OH
44118-4125
US

V. Phone/Fax

Practice location:
  • Phone: 216-321-5705
  • Fax:
Mailing address:
  • Phone: 216-321-5705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number954519
License Number StateOH

VIII. Authorized Official

Name: MR. BABATUNDE MOSHOOD
Title or Position: PRESIDENT
Credential:
Phone: 216-321-5705