Provider Demographics
NPI:1265936884
Name:GOLD STRIDES GROUP LLC
Entity type:Organization
Organization Name:GOLD STRIDES GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:IMOUDU
Authorized Official - Middle Name:
Authorized Official - Last Name:EDEKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-206-0195
Mailing Address - Street 1:13155 NOEL RD STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6882
Mailing Address - Country:US
Mailing Address - Phone:940-206-0195
Mailing Address - Fax:
Practice Address - Street 1:13155 NOEL RD STE 900
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6882
Practice Address - Country:US
Practice Address - Phone:940-206-0195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)