Provider Demographics
NPI:1124485164
Name:JOY RIDE METRO TRANSPORT, LLC
Entity type:Organization
Organization Name:JOY RIDE METRO TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:W
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-331-1100
Mailing Address - Street 1:3105 SE MIEHE DR
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-6657
Mailing Address - Country:US
Mailing Address - Phone:515-331-1100
Mailing Address - Fax:
Practice Address - Street 1:3105 SE MIEHE DR
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-6657
Practice Address - Country:US
Practice Address - Phone:515-331-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)