Provider Demographics
NPI:1235442898
Name:ROADRUNNER EXPRESS, LLC
Entity Type:Organization
Organization Name:ROADRUNNER EXPRESS, LLC
Other - Org Name:ACE TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:
Authorized Official - First Name:KHERLENCHIMEG
Authorized Official - Middle Name:
Authorized Official - Last Name:BAASANDAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-608-1315
Mailing Address - Street 1:PO BOX 957
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94017-0957
Mailing Address - Country:US
Mailing Address - Phone:800-608-1315
Mailing Address - Fax:888-315-5419
Practice Address - Street 1:2345 BALBOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2912
Practice Address - Country:US
Practice Address - Phone:800-608-1315
Practice Address - Fax:888-315-5419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN/A343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)