Healthcare Provider Details

I. General information

NPI: 1497090153
Provider Name (Legal Business Name): SHARE RIDE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6436 SPRINGCREST LN
RICHMOND VA
23231-5324
US

IV. Provider business mailing address

6436 SPRINGCREST LN
RICHMOND VA
23231-5324
US

V. Phone/Fax

Practice location:
  • Phone: 804-296-2963
  • Fax:
Mailing address:
  • Phone: 804-296-2963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateVA

VIII. Authorized Official

Name: MR. SHAUN T ROBERSON
Title or Position: CO - OWNER
Credential:
Phone: 804-296-2963