Provider Demographics
NPI:1194863571
Name:SAFE RIDE TRANSPORT, INC.
Entity Type:Organization
Organization Name:SAFE RIDE TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-806-8280
Mailing Address - Street 1:6515 E LIVINGSTON AVE
Mailing Address - Street 2:SUITE B-11
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3562
Mailing Address - Country:US
Mailing Address - Phone:614-322-9490
Mailing Address - Fax:614-322-9495
Practice Address - Street 1:6515 E LIVINGSTON AVE
Practice Address - Street 2:SUITE B-11
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3562
Practice Address - Country:US
Practice Address - Phone:614-322-9490
Practice Address - Fax:614-322-9495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHMTB-5670343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2529857Medicaid