Provider Demographics
NPI:1255018123
Name:GOLD RIDE LLC
Entity type:Organization
Organization Name:GOLD RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MESERET
Authorized Official - Middle Name:T
Authorized Official - Last Name:ESTIFANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-492-7581
Mailing Address - Street 1:9695 E ARKANSAS PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-5698
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:78 N SILICON DR BLDG 1
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81007-1462
Practice Address - Country:US
Practice Address - Phone:720-492-7581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)