Provider Demographics
NPI:1952797375
Name:RIVERSIDE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:RIVERSIDE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GERITY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:410-845-8687
Mailing Address - Street 1:1380 ODENTON RD
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1503
Mailing Address - Country:US
Mailing Address - Phone:410-845-8687
Mailing Address - Fax:410-874-3108
Practice Address - Street 1:1380 ODENTON RD
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1503
Practice Address - Country:US
Practice Address - Phone:410-845-8687
Practice Address - Fax:410-874-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X, 343800000X, 344600000X
MD4720343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi