Provider Demographics
NPI:1497440598
Name:ELYON RIDE LLC
Entity Type:Organization
Organization Name:ELYON RIDE LLC
Other - Org Name:ELYON RIDE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IZONDERERA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEUDONNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-762-9095
Mailing Address - Street 1:7231 MELROSE LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-4457
Mailing Address - Country:US
Mailing Address - Phone:832-762-9095
Mailing Address - Fax:
Practice Address - Street 1:7231 MELROSE LN
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-4457
Practice Address - Country:US
Practice Address - Phone:832-762-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)