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General NPI Number Information
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NPI Number | 1972398287
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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 | 04/09/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1521 E PONCHO LN
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-3221
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Country | US
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Telephone | 480-859-5355
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 W CLARENDON AVE UNIT 112
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City | PHOENIX
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State | AZ
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Zip | 85019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | NEVAEH WHITE
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Credential |
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Telephone | 480-859-5355
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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 |
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