Provider Demographics
NPI:1285473926
Name:BUDDY RIDE LLC
Entity type:Organization
Organization Name:BUDDY RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-990-6078
Mailing Address - Street 1:1761 CHURCH ST UNIT 109
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2313
Mailing Address - Country:US
Mailing Address - Phone:757-440-3125
Mailing Address - Fax:757-481-8259
Practice Address - Street 1:1761 CHURCH ST UNIT 109
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2313
Practice Address - Country:US
Practice Address - Phone:757-440-3125
Practice Address - Fax:757-481-8259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)