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General NPI Number Information
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NPI Number | 1952797375
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Entity Type | Organization
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Legal Business Name | RIVERSIDE TRANSPORTATION LLC
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 1380 ODENTON RD
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City | ODENTON
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State | MD
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Zip | 21113-1503
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Country | US
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Telephone | 410-845-8687
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Fax | 410-874-3108
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Provider Business Mailing Address
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Address Line | 1380 ODENTON RD
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City | ODENTON
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State | MD
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Zip | 21113-1503
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Country | US
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Telephone | 410-845-8687
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Fax | 410-874-3108
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | MR. JONATHAN LEE GERITY SR.
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Credential |
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Telephone | 410-845-8687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 4720
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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