Provider Demographics
NPI:1578878096
Name:LUXE RIDE SERVICE LLC
Entity Type:Organization
Organization Name:LUXE RIDE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-707-7413
Mailing Address - Street 1:15 S GARFIELD AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-5002
Mailing Address - Country:US
Mailing Address - Phone:614-707-7413
Mailing Address - Fax:
Practice Address - Street 1:15 S GARFIELD AVE
Practice Address - Street 2:APT 2
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-5002
Practice Address - Country:US
Practice Address - Phone:614-707-7413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSJ424753343900000X
OHSN568256347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)