Provider Demographics
NPI:1598953671
Name:RIDGEWAY TRANSPORTATION LLC
Entity Type:Organization
Organization Name:RIDGEWAY TRANSPORTATION LLC
Other - Org Name:RIDGEWAY MEDICAL TRANSPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:RIDGEWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-271-4031
Mailing Address - Street 1:PO BOX 211377
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91921-1377
Mailing Address - Country:US
Mailing Address - Phone:619-271-4031
Mailing Address - Fax:619-271-4032
Practice Address - Street 1:1251 3RD AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3261
Practice Address - Country:US
Practice Address - Phone:619-271-4031
Practice Address - Fax:619-271-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-14
Last Update Date:2007-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16856343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)