Provider Demographics
NPI:1497221667
Name:RIDE WELL CORP
Entity Type:Organization
Organization Name:RIDE WELL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAME
Authorized Official - Middle Name:BOUSSO
Authorized Official - Last Name:DIOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-850-3261
Mailing Address - Street 1:21810 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5712
Mailing Address - Country:US
Mailing Address - Phone:313-850-3261
Mailing Address - Fax:313-273-7452
Practice Address - Street 1:21810 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5712
Practice Address - Country:US
Practice Address - Phone:313-850-3261
Practice Address - Fax:313-273-7452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)