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General NPI Number Information
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NPI Number | 1144999707
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Entity Type | Organization
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Legal Business Name | RAIDER MOBILITY CARE, LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 4601 50TH ST STE 112
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City | LUBBOCK
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State | TX
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Zip | 79414-3514
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Country | US
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Telephone | 806-239-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 50TH ST STE 112
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City | LUBBOCK
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State | TX
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Zip | 79414-3514
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Country | US
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Telephone | 806-239-7616
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID TYLER BAINS
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Credential | EMT-P, FP-C, CCP-C
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Telephone | 806-239-7616
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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 |
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License Number State |
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