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General NPI Number Information
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NPI Number | 1689867111
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Entity Type | Organization
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Legal Business Name | EXPRESS RIDE
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 3330 TIDEWATER CT
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City | OLNEY
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State | MD
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Zip | 20832-1424
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Country | US
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Telephone | 240-421-0938
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Fax | 301-570-8902
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Provider Business Mailing Address
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Address Line | 3330 TIDEWATER CT
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City | OLNEY
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State | MD
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Zip | 20832-1424
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Country | US
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Telephone | 240-421-0938
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Fax | 301-570-8902
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Authorized Official
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Title or Position | CEO
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Name | MR. ABEBE TEKLEMARIAM ALEMU
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Credential |
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Telephone | 240-421-0938
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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 | 1365
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License Number State | DC
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