MEDICARE: REAL RIDE 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	:	1568167096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAL RIDE LLC

Provider Business Mailing Address
First Line	:	10050 E HARVARD AVE APT C32
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3923
Country	:	US
Telephone Number	:	720-886-1142
Fax Number	:	303-667-7198

Provider Business Practice Location Address
First Line	:	10050 E HARVARD AVE APT C32
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3923
Country	:	US
Telephone Number	:	720-886-1142
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SOLOMON GEBREZGHI GEBRIT
Credential	:
Telephone Number	:	720-869-1149

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	04/03/2023

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Directions to “REAL RIDE LLC ” Practice Location

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