Provider Demographics
NPI:1902667991
Name:PULSERIDE LLC
Entity Type:Organization
Organization Name:PULSERIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXEY
Authorized Official - Middle Name:V
Authorized Official - Last Name:GRIBCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-877-3575
Mailing Address - Street 1:17100 N BAY RD APT 1506
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3458
Mailing Address - Country:US
Mailing Address - Phone:305-877-3575
Mailing Address - Fax:
Practice Address - Street 1:17100 N BAY RD APT 1506
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3458
Practice Address - Country:US
Practice Address - Phone:305-877-3575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)