Provider Demographics
NPI:1033700869
Name:CITYRIDE, INC
Entity Type:Organization
Organization Name:CITYRIDE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLUSEGUN
Authorized Official - Middle Name:F
Authorized Official - Last Name:OSOSANYA
Authorized Official - Suffix:
Authorized Official - Credentials:MA PSYCH
Authorized Official - Phone:757-277-3552
Mailing Address - Street 1:804 ANGLIA CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-2381
Mailing Address - Country:US
Mailing Address - Phone:757-277-3552
Mailing Address - Fax:757-299-8005
Practice Address - Street 1:900 COMMONWEALTH PL
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4517
Practice Address - Country:US
Practice Address - Phone:757-277-3552
Practice Address - Fax:757-299-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)