Organization
EASY RIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BASHIR SAAD ALGELLAL OWNER (MANAGER)
(503) 954-6137
Entity
Organization
Contact information
Practice address
8973 N FISKE AVE, PORTLAND, OR 97203-3576
(503) 954-6737
Mailing address
8973 N FISKE AVE, PORTLAND, OR 97203-3576
(503) 954-6737
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1361419-91
—
OR
Enumeration date
06/27/2022
Last updated
06/27/2022
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