Provider Demographics
NPI:1023549128
Name:ANTELOPE VALLEY RIDE INC.
Entity Type:Organization
Organization Name:ANTELOPE VALLEY RIDE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GULNARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURADYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-886-4496
Mailing Address - Street 1:1722 MARION AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2928
Mailing Address - Country:US
Mailing Address - Phone:661-886-4496
Mailing Address - Fax:661-940-1862
Practice Address - Street 1:1722 MARION AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-2928
Practice Address - Country:US
Practice Address - Phone:661-886-4496
Practice Address - Fax:661-940-1862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriverGroup - Single Specialty