Provider Demographics
NPI:1558127126
Name:BRENDA SUE'S RIDES LLC
Entity Type:Organization
Organization Name:BRENDA SUE'S RIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-534-4725
Mailing Address - Street 1:9015 STAGE COACH RD
Mailing Address - Street 2:
Mailing Address - City:NATHALIE
Mailing Address - State:VA
Mailing Address - Zip Code:24577-3459
Mailing Address - Country:US
Mailing Address - Phone:434-534-4725
Mailing Address - Fax:
Practice Address - Street 1:9015 STAGE COACH RD
Practice Address - Street 2:
Practice Address - City:NATHALIE
Practice Address - State:VA
Practice Address - Zip Code:24577-3459
Practice Address - Country:US
Practice Address - Phone:434-534-4725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)