Provider Demographics
NPI:1457104093
Name:MEDI RIDE
Entity Type:Organization
Organization Name:MEDI RIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:SHERISE
Authorized Official - Last Name:SAVOIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-983-7712
Mailing Address - Street 1:8599 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8023
Mailing Address - Country:US
Mailing Address - Phone:409-983-7711
Mailing Address - Fax:409-985-5233
Practice Address - Street 1:8599 9TH AVE
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8023
Practice Address - Country:US
Practice Address - Phone:409-983-7711
Practice Address - Fax:409-985-5233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRO MED PROVIDERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-11
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)