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General NPI Number Information
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NPI Number | 1063964864
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Entity Type | Organization
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Legal Business Name | MED RIDE
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 10055 N. 142ND ST.# 1130
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City | SCOTTSDALE
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State | AZ
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Zip | 85259
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Country | US
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Telephone | 480-200-8177
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Fax |
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Provider Business Mailing Address
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Address Line | 10055 N 142ND ST UNIT 1130
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5524
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Country | US
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Telephone | 480-200-8177
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAMID K EGHBAL
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Credential | CEO
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Telephone | 480-200-8177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 50174
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License Number State | AZ
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