Provider Demographics
NPI:1467858563
Name:EASY RIDE TRANSPORTATION
Entity Type:Organization
Organization Name:EASY RIDE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-422-1313
Mailing Address - Street 1:6922 TOBIAS AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3933
Mailing Address - Country:US
Mailing Address - Phone:323-422-1313
Mailing Address - Fax:
Practice Address - Street 1:6922 TOBIAS AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3933
Practice Address - Country:US
Practice Address - Phone:323-422-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)