MEDICARE: RIDENOW TRANSPORT, 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1497528640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDENOW TRANSPORT, LLC

Provider Business Mailing Address
First Line	:	332 S 71ST AVE W
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55807-1813
Country	:	US
Telephone Number	:	218-626-5018
Fax Number	:

Provider Business Practice Location Address
First Line	:	332 S 71ST AVE W
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55807-1813
Country	:	US
Telephone Number	:	218-626-5018
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARA CLAUDIA RUSSELL
Credential	:
Telephone Number	:	218-626-5018

Provider Enumeration Date	:	10/31/2023
Last Update Date	:	10/31/2023

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Directions to “RIDENOW TRANSPORT, LLC ” Practice Location

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