Provider Demographics
NPI:1962103556
Name:VAN RIDES LLC
Entity type:Organization
Organization Name:VAN RIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERANCE
Authorized Official - Middle Name:DONELL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-318-9949
Mailing Address - Street 1:702 PEACHERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-5416
Mailing Address - Country:US
Mailing Address - Phone:918-318-9949
Mailing Address - Fax:
Practice Address - Street 1:702 PEACHERS MILL RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-5416
Practice Address - Country:US
Practice Address - Phone:918-318-9949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)