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General NPI Number Information
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NPI Number | 1952837437
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Entity Type | Organization
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Legal Business Name | MEDI RIDE LLC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 724 MCCLAY RD
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City | NOVATO
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State | CA
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Zip | 94947-3863
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Country | US
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Telephone | 415-761-9259
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Fax | 415-761-9259
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Provider Business Mailing Address
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Address Line | 926 A DIABLO AVE STE 207
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City | NOVATO
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State | CA
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Zip | 94947-4025
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Country | US
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Telephone | 415-761-9259
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TESS L BEAGLE
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Credential | OWNER OF COMPANY
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Telephone | 415-761-9259
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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 |
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License Number State | CA
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