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General NPI Number Information
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NPI Number | 1174990741
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Entity Type | Organization
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Legal Business Name | BESTRIDE TRANSPORTATION INC.
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Dates
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Enumeration Date | 08/30/2015
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Last Update Date | 08/30/2015
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Provider Practice Location Address
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Address Line | 1643 N 20TH AVE
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City | MELROSE PARK
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State | IL
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Zip | 60160-1903
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Country | US
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Telephone | 773-507-4465
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Fax | 844-803-7433
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Provider Business Mailing Address
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Address Line | 8232 CONCORD LN UNIT D
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City | JUSTICE
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State | IL
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Zip | 60458-1899
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Country | US
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Telephone | 844-803-7433
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Fax | 844-803-7433
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Authorized Official
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Title or Position | MANAGER
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Name | CARLOS BAUTISTA
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Credential |
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Telephone | 773-742-3489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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