Provider Demographics
NPI:1548938616
Name:MEDI-RYDE, LLC
Entity type:Organization
Organization Name:MEDI-RYDE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:210-454-3602
Mailing Address - Street 1:248 CHAMPIONS RIDGE
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070
Mailing Address - Country:US
Mailing Address - Phone:214-454-3602
Mailing Address - Fax:
Practice Address - Street 1:10615 PERRIN BEITEL RD, BLDG 4
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217
Practice Address - Country:US
Practice Address - Phone:210-549-6128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)