Provider Demographics
NPI:1821688649
Name:PRIDE TRANSIT LLC
Entity Type:Organization
Organization Name:PRIDE TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHSAY
Authorized Official - Suffix:
Authorized Official - Credentials:NEMT
Authorized Official - Phone:503-750-9286
Mailing Address - Street 1:11150 SE CAUSEY CIR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-4709
Mailing Address - Country:US
Mailing Address - Phone:503-750-9286
Mailing Address - Fax:
Practice Address - Street 1:11150 SE CAUSEY CIR
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-4709
Practice Address - Country:US
Practice Address - Phone:503-750-9286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)