Provider Demographics
NPI:1871344713
Name:SOLACE RIDE SERVICE LLC
Entity type:Organization
Organization Name:SOLACE RIDE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIRUWORK
Authorized Official - Middle Name:TSEGAY
Authorized Official - Last Name:HADGAY
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:720-841-9309
Mailing Address - Street 1:2205 BRIARCREST DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-1657
Mailing Address - Country:US
Mailing Address - Phone:720-841-9309
Mailing Address - Fax:
Practice Address - Street 1:2205 BRIARCREST DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-1657
Practice Address - Country:US
Practice Address - Phone:720-841-9309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)