Provider Demographics
NPI:1013429075
Name:RICBEN NON-MEDICAL TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:RICBEN NON-MEDICAL TRANSPORTATION SERVICES
Other - Org Name:RICBEN NON-MEDICAL TRANSPORTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENDU
Authorized Official - Middle Name:MCBORROUGH
Authorized Official - Last Name:DAWOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-836-1869
Mailing Address - Street 1:17802 RED WOLF DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1037
Mailing Address - Country:US
Mailing Address - Phone:281-781-6473
Mailing Address - Fax:
Practice Address - Street 1:17802 RED WOLF DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084
Practice Address - Country:US
Practice Address - Phone:281-781-6473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26-3352663Medicaid