Healthcare Provider Details

I. General information

NPI: 1740896190
Provider Name (Legal Business Name): CITY RIDES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 LANSING ST
PHILADELPHIA PA
19136-3034
US

IV. Provider business mailing address

3402 LANSING ST
PHILADELPHIA PA
19136-3034
US

V. Phone/Fax

Practice location:
  • Phone: 267-478-2433
  • Fax:
Mailing address:
  • Phone:
  • 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: DENNIS MELTON
Title or Position: DIRECTOR
Credential:
Phone: 267-478-2433