MEDICARE: BLESS A RIDER 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	:	1558960542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESS A RIDER LLC

Provider Business Mailing Address
First Line	:	5821 WOODHAVEN CIR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-1435
Country	:	US
Telephone Number	:	910-536-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 WALSH PKWY
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-1642
Country	:	US
Telephone Number	:	919-536-2211
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. JOSEPH NATHAN MCKAY
Credential	:
Telephone Number	:	919-536-2211

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	10/20/2020

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Directions to “BLESS A RIDER LLC ” Practice Location

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