Provider Demographics
NPI:1245969815
Name:FIRSTCLASSRIDES LLC
Entity type:Organization
Organization Name:FIRSTCLASSRIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:OBRIAN
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-822-3230
Mailing Address - Street 1:160 OLD TAVERN CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-7748
Mailing Address - Country:US
Mailing Address - Phone:434-822-3230
Mailing Address - Fax:
Practice Address - Street 1:1417 TARDY MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517-3015
Practice Address - Country:US
Practice Address - Phone:434-700-5698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)