Provider Demographics
NPI:1003781089
Name:VITAL RIDES LLC
Entity type:Organization
Organization Name:VITAL RIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:STS
Authorized Official - Phone:507-829-3592
Mailing Address - Street 1:6889 CLEARWATER RD APT 212
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-2020
Mailing Address - Country:US
Mailing Address - Phone:507-829-3592
Mailing Address - Fax:218-454-0078
Practice Address - Street 1:6889 CLEARWATER RD APT 212
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-2020
Practice Address - Country:US
Practice Address - Phone:507-829-3592
Practice Address - Fax:218-454-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)