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General NPI Number Information
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NPI Number | 1639325269
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Entity Type | Organization
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Legal Business Name | PRIDE INDUSTRIES ONE, INC.
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 10030 FOOTHILLS BLVD M/S 26
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City | ROSEVILLE
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State | CA
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Zip | 95747-5178
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Country | US
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Telephone | 916-788-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 10030 FOOTHILLS BLVD M/S 26
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City | ROSEVILLE
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State | CA
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Zip | 95747-5178
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Country | US
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Telephone | 916-788-2100
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Fax |
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Authorized Official
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Title or Position | TRANSPORTATION MANAGER
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Name | JOAN PEDERSON
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Credential |
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Telephone | 916-788-2327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number | CA-45685
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License Number State | CA
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