Provider Demographics
NPI:1477374288
Name:JM RIDE CARE MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:JM RIDE CARE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAKSIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZAKEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-433-1394
Mailing Address - Street 1:1124 N LA CIENEGA BLVD
Mailing Address - Street 2:208
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069
Mailing Address - Country:US
Mailing Address - Phone:360-433-1394
Mailing Address - Fax:
Practice Address - Street 1:1124 N LA CIENEGA BLVD
Practice Address - Street 2:208
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069
Practice Address - Country:US
Practice Address - Phone:360-433-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)