Provider Demographics
NPI:1356693014
Name:ADVANCE ACCESS RIDE LLC
Entity type:Organization
Organization Name:ADVANCE ACCESS RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-781-6159
Mailing Address - Street 1:2045 COMPTON AVE
Mailing Address - Street 2:SUITE NUMBER 203
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-7286
Mailing Address - Country:US
Mailing Address - Phone:951-263-2649
Mailing Address - Fax:951-547-3653
Practice Address - Street 1:2045 COMPTON AVE
Practice Address - Street 2:SUITE NUMBER 203
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-7286
Practice Address - Country:US
Practice Address - Phone:951-263-2649
Practice Address - Fax:951-547-3653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCP0027004 - B343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)