Provider Demographics
NPI:1669935664
Name:SU PRIDE TAXI
Entity type:Organization
Organization Name:SU PRIDE TAXI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANOHAR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:CHOPRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-516-0566
Mailing Address - Street 1:100 TERRACEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1214
Mailing Address - Country:US
Mailing Address - Phone:315-516-0566
Mailing Address - Fax:
Practice Address - Street 1:100 TERRACEVIEW RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1214
Practice Address - Country:US
Practice Address - Phone:315-516-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)