Provider Demographics
NPI:1124620075
Name:LONESTAR RIDES LLC
Entity type:Organization
Organization Name:LONESTAR RIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATOSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-373-6155
Mailing Address - Street 1:4041 MEDICAL DR APT 306
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2157
Mailing Address - Country:US
Mailing Address - Phone:646-373-6155
Mailing Address - Fax:
Practice Address - Street 1:4041 MEDICAL DR APT 306
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2157
Practice Address - Country:US
Practice Address - Phone:646-373-6155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)