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General NPI Number Information
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NPI Number | 1851115265
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Entity Type | Organization
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Legal Business Name | SUNSHINE RIDE LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 4423 STOCKDALE LN
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City | FORNEY
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State | TX
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Zip | 75126-3386
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Country | US
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Telephone | 720-862-4845
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Fax |
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Provider Business Mailing Address
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Address Line | 4423 STOCKDALE LN
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City | FORNEY
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State | TX
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Zip | 75126-3386
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Country | US
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Telephone | 720-862-4845
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Fax |
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Authorized Official
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Title or Position | OWNER/ MANAGER MEMBER
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Name | TADELE MEKONNEN
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Credential |
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Telephone | 720-862-4845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1103X
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Taxonomy Name | Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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