Provider Demographics
NPI:1316765696
Name:SPIRITUAL RIDER'S MEDICAL TRANSPORTATION, LLC.
Entity type:Organization
Organization Name:SPIRITUAL RIDER'S MEDICAL TRANSPORTATION, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-300-9639
Mailing Address - Street 1:13313 CUTTEN RD APT 8212
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2379
Mailing Address - Country:US
Mailing Address - Phone:346-300-9639
Mailing Address - Fax:
Practice Address - Street 1:13313 CUTTEN RD APT 8212
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2379
Practice Address - Country:US
Practice Address - Phone:346-300-9639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)