1184805798 NPI number — LET'S RIDE MOBILITY SERVICES, LLC

Table of content: (NPI 1184805798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184805798 NPI number — LET'S RIDE MOBILITY SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LET'S RIDE MOBILITY SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184805798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 745823
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARVADA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80006-5823
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-214-2882
Provider Business Mailing Address Fax Number:
720-269-0022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8223 DEPEW WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARVADA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80003-1819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-381-6399
Provider Business Practice Location Address Fax Number:
720-269-0022
Provider Enumeration Date:
11/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
WILLARD EDWARD
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
18772142882

Provider Taxonomy Codes

  • Taxonomy code: 344600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05978874 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".