Provider Demographics
NPI:1568713493
Name:IRIDE TRANSPORT SERVICES, LLC
Entity Type:Organization
Organization Name:IRIDE TRANSPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:B
Authorized Official - Last Name:ALBANO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:408-223-1619
Mailing Address - Street 1:3296 MONTE VERDE LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-2318
Mailing Address - Country:US
Mailing Address - Phone:408-223-1619
Mailing Address - Fax:408-270-4816
Practice Address - Street 1:3296 MONTE VERDE LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-2318
Practice Address - Country:US
Practice Address - Phone:408-223-1619
Practice Address - Fax:408-270-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201203010136343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)