Provider Demographics
NPI:1235938762
Name:TELIYADU RIDE LLC
Entity type:Organization
Organization Name:TELIYADU RIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WENDEMAGEN
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-728-5260
Mailing Address - Street 1:225 N SABLE BLVD UNIT 10315
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-0827
Mailing Address - Country:US
Mailing Address - Phone:505-728-5260
Mailing Address - Fax:
Practice Address - Street 1:685 CITADEL DR E STE 290-7
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5314
Practice Address - Country:US
Practice Address - Phone:719-757-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)