Provider Demographics
NPI:1487210274
Name:E-Z RIDE HOME TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:E-Z RIDE HOME TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-297-9248
Mailing Address - Street 1:6408 N WOODSTOCK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-3032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6408 N WOODSTOCK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-3032
Practice Address - Country:US
Practice Address - Phone:267-297-9248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)