Organization
COHESIVE MEDIRYDE
Active
Other names
Cohesive Mediryde
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY ZEIGLER (CREDENTIALING OPERATIONS)
(918) 902-0460
Entity
Organization
Contact information
Practice address
1616 S STATE ST, EDMOND, OK 73013-3600
(405) 395-4474
Mailing address
2510 E INDEPENDENCE ST, SHAWNEE, OK 74804-1839
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200828770A
—
OK
Enumeration date
04/02/2019
Last updated
05/24/2019
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