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General NPI Number Information
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NPI Number | 1083771620
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Entity Type | Organization
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Legal Business Name | MED RIDE INC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 101 SMITH STREET
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City | JAMESTOWN
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State | TN
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Zip | 38556-0503
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Country | US
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Telephone | 931-752-7433
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 503
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City | JAMESTOWN
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State | TN
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Zip | 38556-0503
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Country | US
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Telephone | 931-752-7433
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. JOEL L ROSS
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Credential | CPA
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Telephone | 931-879-7036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 339801
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License Number State | TN
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