Provider Demographics
NPI:1790414134
Name:MED RIDE LLC
Entity type:Organization
Organization Name:MED RIDE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER , GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-281-2859
Mailing Address - Street 1:2125 S 48TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1014
Mailing Address - Country:US
Mailing Address - Phone:602-354-4463
Mailing Address - Fax:
Practice Address - Street 1:2125 S 48TH ST STE 103
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1014
Practice Address - Country:US
Practice Address - Phone:602-354-4463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)