MEDICARE: SOFT RIDES MEDICAL TRANSPORTER 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	:	1831982685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOFT RIDES MEDICAL TRANSPORTER LLC

Provider Business Mailing Address
First Line	:	4707 LEE ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71302-3238
Country	:	US
Telephone Number	:	318-229-9315
Fax Number	:

Provider Business Practice Location Address
First Line	:	4707 LEE ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71302-3238
Country	:	US
Telephone Number	:	318-229-9315
Fax Number	:	318-229-9315

Authorized Official
Title or Position	:	OWNER
Name	:	AZZAM JABBAR
Credential	:
Telephone Number	:	318-229-9315

Provider Enumeration Date	:	05/26/2025
Last Update Date	:	05/26/2025

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