Provider Demographics
NPI:1154841781
Name:UNIVERSAL RIDE SERVICES LLC
Entity Type:Organization
Organization Name:UNIVERSAL RIDE SERVICES LLC
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SINISHAW
Authorized Official - Middle Name:BEKELE
Authorized Official - Last Name:ITICHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-250-8917
Mailing Address - Street 1:1155 OFFICE PARK RD APT 100
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2540
Mailing Address - Country:US
Mailing Address - Phone:515-250-8917
Mailing Address - Fax:
Practice Address - Street 1:1155 OFFICE PARK RD APT 100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2540
Practice Address - Country:US
Practice Address - Phone:515-250-8917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA343900000XMedicaid