Provider Demographics
NPI:1689867111
Name:EXPRESS RIDE
Entity Type:Organization
Organization Name:EXPRESS RIDE
Other - Org Name:EXPRESS RIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ABEBE
Authorized Official - Middle Name:TEKLEMARIAM
Authorized Official - Last Name:ALEMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-421-0938
Mailing Address - Street 1:3330 TIDEWATER CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1424
Mailing Address - Country:US
Mailing Address - Phone:240-421-0938
Mailing Address - Fax:301-570-8902
Practice Address - Street 1:3330 TIDEWATER CT
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1424
Practice Address - Country:US
Practice Address - Phone:240-421-0938
Practice Address - Fax:301-570-8902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXPRESS RIDE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1365343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)