MEDICARE: MTSRYDE HOLDINGS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	343800000X	Secured Medical Transport (VAN)
2	344600000X	Taxi
3	347E00000X	Transportation Broker
4	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1295368942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MTSRYDE HOLDINGS LLC

Provider Business Mailing Address
First Line	:	9711 S MASON RD STE 125-361
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-7167
Country	:	US
Telephone Number	:	832-788-2730
Fax Number	:

Provider Business Practice Location Address
First Line	:	7040 LAKELAND AVE N STE 207A
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55428-5622
Country	:	US
Telephone Number	:	832-788-1895
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MISS MINELLA ALEXANDER
Credential	:
Telephone Number	:	832-788-2730

Provider Enumeration Date	:	02/20/2020
Last Update Date	:	02/20/2020

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