Provider Demographics
NPI:1023728375
Name:SECURERIDE TRANSPORTATION LLC
Entity type:Organization
Organization Name:SECURERIDE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-228-9557
Mailing Address - Street 1:167 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:LA
Mailing Address - Zip Code:71456-9709
Mailing Address - Country:US
Mailing Address - Phone:318-228-9557
Mailing Address - Fax:
Practice Address - Street 1:167 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:LA
Practice Address - Zip Code:71456-9709
Practice Address - Country:US
Practice Address - Phone:318-228-9557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)