Provider Demographics
NPI:1336873561
Name:ON TIME MEDI RIDES L.L.C
Entity type:Organization
Organization Name:ON TIME MEDI RIDES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-319-8938
Mailing Address - Street 1:604 BURLINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-7414
Mailing Address - Country:US
Mailing Address - Phone:318-319-8938
Mailing Address - Fax:
Practice Address - Street 1:604 BURLINGTON CIR
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-7414
Practice Address - Country:US
Practice Address - Phone:318-319-8938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)