Provider Demographics
NPI:1740871052
Name:ELDER-RIDE CAREWAGON TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:ELDER-RIDE CAREWAGON TRANSPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUSEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEJOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-406-5465
Mailing Address - Street 1:6115 YORKTOWN MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6821
Mailing Address - Country:US
Mailing Address - Phone:713-487-8087
Mailing Address - Fax:
Practice Address - Street 1:6115 YORKTOWN MEADOW LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6821
Practice Address - Country:US
Practice Address - Phone:713-487-8087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle