=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578438529
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROAD RUNNER RIDES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2025
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1016 CALDWELL ST
-----------------------------------------------------
City | MCMECHEN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26040-1402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-841-8226
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1016 CALDWELL ST
-----------------------------------------------------
City | MCMECHEN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26040-1402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-841-8226
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | JODI ANN A PETTIT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 304-841-2398
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 342000000X
-----------------------------------------------------
Taxonomy Name | Transportation Network Company
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------