MEDICARE: A RIDES MEDICAL TRANSPORTATION, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1285279125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A RIDES MEDICAL TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	6704 ARCHING BRANCH CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-8448
Country	:	US
Telephone Number	:	561-985-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	6704 ARCHING BRANCH CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-8448
Country	:	US
Telephone Number	:	561-985-4600
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	WADI KAHOK
Credential	:
Telephone Number	:	561-985-4600

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	11/14/2019

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