MEDICARE: GEAUX TIME RIDES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	347E00000X	Transportation Broker
3	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1164379509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEAUX TIME RIDES LLC

Provider Business Mailing Address
First Line	:	1 GALLERIA BLVD STE 19004535
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2082
Country	:	US
Telephone Number	:	504-376-9136
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 GALLERIA BLVD STE 19004535
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2082
Country	:	US
Telephone Number	:	504-376-9136
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEYANTE MASON
Credential	:
Telephone Number	:	504-376-9136

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “GEAUX TIME RIDES LLC ” Practice Location

Language	Start Address	Practice Location

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