Provider Demographics
NPI:1366267700
Name:MED-RIDE LOGISTICS INC
Entity type:Organization
Organization Name:MED-RIDE LOGISTICS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMONGBA
Authorized Official - Middle Name:SALIFU
Authorized Official - Last Name:HARUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-214-9720
Mailing Address - Street 1:1222 CALLISTA AVE
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-7001
Mailing Address - Country:US
Mailing Address - Phone:813-214-9720
Mailing Address - Fax:
Practice Address - Street 1:525 WOODLAND SQUARE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-2212
Practice Address - Country:US
Practice Address - Phone:813-214-9720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)