Provider Demographics
NPI:1447451760
Name:MEDRIDE INC
Entity type:Organization
Organization Name:MEDRIDE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NWOKE
Authorized Official - Middle Name:N
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:202-258-5517
Mailing Address - Street 1:9430 LANHAM SEVERN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2670
Mailing Address - Country:US
Mailing Address - Phone:301-918-0011
Mailing Address - Fax:301-918-0044
Practice Address - Street 1:9430 LANHAM SEVERN RD STE 200
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2670
Practice Address - Country:US
Practice Address - Phone:301-918-0011
Practice Address - Fax:301-918-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCWMATC 535343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)