Provider Demographics
NPI:1568282564
Name:RIDE4HEALTH WYANDOTTE KS LLC
Entity type:Organization
Organization Name:RIDE4HEALTH WYANDOTTE KS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:814-934-2100
Mailing Address - Street 1:11111 HASKELL AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-4428
Mailing Address - Country:US
Mailing Address - Phone:412-881-5466
Mailing Address - Fax:
Practice Address - Street 1:11111 HASKELL AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-4428
Practice Address - Country:US
Practice Address - Phone:412-881-5466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIDE4HEALTH, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)