Provider Demographics
NPI:1144606062
Name:SAFE RIDES MEDTRANS
Entity Type:Organization
Organization Name:SAFE RIDES MEDTRANS
Other - Org Name:SAFE RIDES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DEBOR
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-572-3376
Mailing Address - Street 1:777 CAMPUS COMMONS RD
Mailing Address - Street 2:SUITE 200 #58
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-8309
Mailing Address - Country:US
Mailing Address - Phone:916-572-3376
Mailing Address - Fax:
Practice Address - Street 1:777 CAMPUS COMMONS RD
Practice Address - Street 2:SUITE 200 #58
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-8309
Practice Address - Country:US
Practice Address - Phone:916-572-3376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7425073343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)