Eagle Ride Inc

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

209 LCB Issued in MN

Legal business name

EAGLE RIDE INC

Practice address

6725 Ashwood Rd Apt 310
Woodbury, MN 55125-2279

Phone

(161) 263-6912

NPI assigned

Jan 19, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ali Mohamed Ibrahim

Title

President/Ceo

Phone

(612) 636-9129

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1457718603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 ASHWOOD RD APT 310",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252279",
            "telephone_number": "161-263-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 ASHWOOD RD APT 310",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252279",
            "telephone_number": "161-263-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "612-636-9129",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MN",
            "license": "209 LCB",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Non-emergency Medical Transport (VAN) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.