NPI Code Details Logo

NPI 1255953253

NPI 1255953253 : RIDE CARE : BROOKHAVEN, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1255953253
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    RIDE CARE 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/12/2020
-----------------------------------------------------
    Last Update Date     |    05/12/2020
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2002 SUMMIT BLVD 
-----------------------------------------------------
    City                 |    BROOKHAVEN
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30319-1560
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    404-882-8822
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    115 PARK MEADOWS DRIVE 
-----------------------------------------------------
    City                 |    LAWRENCEVILLE
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30044
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    404-882-8822
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    MANAGER
-----------------------------------------------------
    Name                 |     OLLIS  THOMAS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    404-882-8822
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    347C00000X
-----------------------------------------------------
    Taxonomy Name        |    Private Vehicle
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    347E00000X
-----------------------------------------------------
    Taxonomy Name        |    Transportation Broker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    343900000X
-----------------------------------------------------
    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.