Provider Demographics
NPI:1356159362
Name:REVERSEBUS FOUNDATION
Entity type:Organization
Organization Name:REVERSEBUS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIMITRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:818-312-3374
Mailing Address - Street 1:17919 ALBANY CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9656
Mailing Address - Country:US
Mailing Address - Phone:818-312-3374
Mailing Address - Fax:
Practice Address - Street 1:17919 ALBANY CT
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-9656
Practice Address - Country:US
Practice Address - Phone:818-312-3374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No251V00000XAgenciesVoluntary or Charitable
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi