Provider Demographics
NPI:1396230264
Name:DR RIDES, LLC
Entity Type:Organization
Organization Name:DR RIDES, LLC
Other - Org Name:DR RIDES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DERBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-214-0018
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-0605
Mailing Address - Country:US
Mailing Address - Phone:388-931-8400
Mailing Address - Fax:
Practice Address - Street 1:312 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-3646
Practice Address - Country:US
Practice Address - Phone:386-931-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-24
Last Update Date:2018-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)