Provider Demographics
NPI:1174221329
Name:SUPERIOR RIDES LLC
Entity type:Organization
Organization Name:SUPERIOR RIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:WOODSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS QP
Authorized Official - Phone:336-362-0460
Mailing Address - Street 1:5608 FISHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9083
Mailing Address - Country:US
Mailing Address - Phone:336-362-0460
Mailing Address - Fax:
Practice Address - Street 1:5608 FISHERMAN DR
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9083
Practice Address - Country:US
Practice Address - Phone:336-362-0460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)