Provider Demographics
NPI:1699340562
Name:RIDE4HEALTH DFW
Entity type:Organization
Organization Name:RIDE4HEALTH DFW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
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 1:2510 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76164-6968
Mailing Address - Country:US
Mailing Address - Phone:214-396-9791
Mailing Address - Fax:412-317-1570
Practice Address - Street 1:2510 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76164-6968
Practice Address - Country:US
Practice Address - Phone:214-396-9791
Practice Address - Fax:412-317-1570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIDE4HEALTH, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)