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General NPI Number Information
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NPI Number | 1548938616
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Entity Type | Organization
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Legal Business Name | MEDI-RYDE, LLC
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 10615 PERRIN BEITEL RD, BLDG 4 SUITE 401
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 210-549-6128
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Fax |
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Provider Business Mailing Address
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Address Line | 248 CHAMPIONS RIDGE
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City | SPRING BRANCH
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State | TX
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Zip | 78070
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Country | US
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Telephone | 214-454-3602
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. DEREK MORTON SR.
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Credential |
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Telephone | 210-454-3602
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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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