Provider Demographics
NPI:1457027138
Name:SAFE RIDE MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:SAFE RIDE MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUSIF
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:FAGIR
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL TRANSPORT
Authorized Official - Phone:480-717-9788
Mailing Address - Street 1:PO BOX 7437
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-7437
Mailing Address - Country:US
Mailing Address - Phone:480-717-9788
Mailing Address - Fax:
Practice Address - Street 1:1900 W CARLA VISTA DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-8201
Practice Address - Country:US
Practice Address - Phone:800-275-8777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)