Provider Demographics
NPI:1083089098
Name:VETERANS RIDESHARE, INC.
Entity Type:Organization
Organization Name:VETERANS RIDESHARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:DERWIN
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-801-6659
Mailing Address - Street 1:9624 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6636
Mailing Address - Country:US
Mailing Address - Phone:855-801-6659
Mailing Address - Fax:
Practice Address - Street 1:9624 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6636
Practice Address - Country:US
Practice Address - Phone:855-801-6659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)