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General NPI Number Information
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NPI Number | 1972043255
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Entity Type | Organization
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Legal Business Name | RIDE WITH FOREFATHERS LLC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 1911 LAUREL OAK CT
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City | ARLINGTON
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State | TX
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Zip | 76001-8461
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Country | US
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Telephone | 682-556-2463
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 LAUREL OAK CT
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City | ARLINGTON
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State | TX
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Zip | 76001-8461
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Country | US
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Telephone | 682-556-2463
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. TIMOTHY LEE MILTON JR.
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Credential |
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Telephone | 682-556-2463
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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 | 24407649
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License Number State | TX
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