Provider Demographics
NPI:1609549781
Name:ARIZONA ELDER-RIDE
Entity Type:Organization
Organization Name:ARIZONA ELDER-RIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-575-9893
Mailing Address - Street 1:8245 N 27TH AVE APT 230
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-6375
Mailing Address - Country:US
Mailing Address - Phone:770-572-9893
Mailing Address - Fax:
Practice Address - Street 1:8245 N 27TH AVE APT 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-6375
Practice Address - Country:US
Practice Address - Phone:770-572-9893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)