Provider Demographics
NPI:1750157954
Name:RADDS MEDICARE LLC
Entity type:Organization
Organization Name:RADDS MEDICARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:N
Authorized Official - Last Name:GITAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-420-8550
Mailing Address - Street 1:2604 62ND AVE E APT D
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-3005
Mailing Address - Country:US
Mailing Address - Phone:469-420-8550
Mailing Address - Fax:
Practice Address - Street 1:2604 62ND AVE E APT D
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-3005
Practice Address - Country:US
Practice Address - Phone:469-420-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker