Provider Demographics
NPI:1871301945
Name:MY MOBILITY RIDE
Entity type:Organization
Organization Name:MY MOBILITY RIDE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-255-5195
Mailing Address - Street 1:PO BOX 83012
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-8014
Mailing Address - Country:US
Mailing Address - Phone:678-255-5195
Mailing Address - Fax:
Practice Address - Street 1:1970 MAIN ST E STE B142
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6463
Practice Address - Country:US
Practice Address - Phone:678-255-5195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle