=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760338263
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARE RIDE EXPRESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2026
-----------------------------------------------------
Last Update Date | 03/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4657 PROSPECT RD
-----------------------------------------------------
City | MAXTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28364-9051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-774-4286
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 701
-----------------------------------------------------
City | PEMBROKE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28372-0701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-774-4286
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JABRIE BULLARD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 910-774-4286
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------