Provider Demographics
NPI:1093944118
Name:HANDIRIDES OF NEVADA
Entity Type:Organization
Organization Name:HANDIRIDES OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEFREZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-240-7433
Mailing Address - Street 1:1050 S RAINBOW BLVD
Mailing Address - Street 2:# 290
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-6231
Mailing Address - Country:US
Mailing Address - Phone:702-240-7433
Mailing Address - Fax:
Practice Address - Street 1:1050 S RAINBOW BLVD
Practice Address - Street 2:# 290
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-6231
Practice Address - Country:US
Practice Address - Phone:702-240-7433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)