Provider Demographics
NPI:1750745386
Name:D.R. MEDICAL RIDES OF ILLINOIS
Entity type:Organization
Organization Name:D.R. MEDICAL RIDES OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-279-7984
Mailing Address - Street 1:4539 WOODGATE DR STE A
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-8205
Mailing Address - Country:US
Mailing Address - Phone:608-279-7984
Mailing Address - Fax:
Practice Address - Street 1:4539 WOODGATE DR STE A
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-8205
Practice Address - Country:US
Practice Address - Phone:608-279-7984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRM GLOBAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-10
Last Update Date:2016-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)