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General NPI Number Information
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NPI Number | 1295518918
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Entity Type | Organization
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Legal Business Name | MIDWEST MEDICAL RIDES, LLC
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 1253 N 25TH ST
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City | FORT DODGE
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State | IA
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Zip | 50501-2110
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Country | US
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Telephone | 515-302-4761
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Fax |
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Provider Business Mailing Address
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Address Line | 728 1ST AVE N STE 9
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City | FORT DODGE
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State | IA
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Zip | 50501-3804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KEELY GRELL
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Credential |
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Telephone | 515-302-4761
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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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