Provider Demographics
NPI:1629876503
Name:PEANUT RIDES INC
Entity type:Organization
Organization Name:PEANUT RIDES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:GWEN
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-380-7865
Mailing Address - Street 1:4688 MOUNTAIN CREEK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-6803
Mailing Address - Country:US
Mailing Address - Phone:704-380-7865
Mailing Address - Fax:
Practice Address - Street 1:4688 MOUNTAIN CREEK AVE STE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-6803
Practice Address - Country:US
Practice Address - Phone:704-380-7865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle