Provider Demographics
NPI:1326727819
Name:RIDESOURCE INC.
Entity Type:Organization
Organization Name:RIDESOURCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-743-7433
Mailing Address - Street 1:1 ALCOTT ST
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-5612
Mailing Address - Country:US
Mailing Address - Phone:207-743-7433
Mailing Address - Fax:207-739-1086
Practice Address - Street 1:1 ALCOTT ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5612
Practice Address - Country:US
Practice Address - Phone:207-743-7433
Practice Address - Fax:207-739-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)