Provider Demographics
NPI:1366719890
Name:CARE RIDE, LLC
Entity type:Organization
Organization Name:CARE RIDE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JONNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-866-1193
Mailing Address - Street 1:4625 E BAY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-5738
Mailing Address - Country:US
Mailing Address - Phone:727-866-1193
Mailing Address - Fax:727-866-0148
Practice Address - Street 1:4625 E BAY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-5738
Practice Address - Country:US
Practice Address - Phone:727-866-1193
Practice Address - Fax:727-866-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)