Provider Demographics
NPI:1992080790
Name:JANNIE'S RIDE INC
Entity type:Organization
Organization Name:JANNIE'S RIDE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIGHTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-723-7561
Mailing Address - Street 1:205 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-8489
Mailing Address - Country:US
Mailing Address - Phone:919-723-7561
Mailing Address - Fax:919-553-2490
Practice Address - Street 1:205 GRANT ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-8489
Practice Address - Country:US
Practice Address - Phone:919-723-7561
Practice Address - Fax:919-553-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)