Provider Demographics
NPI:1922780683
Name:RIVERS, JARET
Entity Type:Individual
Prefix:
First Name:JARET
Middle Name:
Last Name:RIVERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W CENTRAL AVE UNIT 1320
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85128-4783
Mailing Address - Country:US
Mailing Address - Phone:407-557-0218
Mailing Address - Fax:
Practice Address - Street 1:229 W CENTRAL AVE UNIT 1320
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85128-4783
Practice Address - Country:US
Practice Address - Phone:407-557-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No347E00000XTransportation ServicesTransportation Broker