Provider Demographics
NPI:1447410360
Name:RIVERSIDE TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:RIVERSIDE TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDISAMAD
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-457-4776
Mailing Address - Street 1:149 THOMPSON AVE E
Mailing Address - Street 2:SUITE 213
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3238
Mailing Address - Country:US
Mailing Address - Phone:651-457-4776
Mailing Address - Fax:651-457-4873
Practice Address - Street 1:149 THOMPSON AVE E
Practice Address - Street 2:SUITE 213
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3238
Practice Address - Country:US
Practice Address - Phone:651-457-4776
Practice Address - Fax:651-457-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)