Healthcare Provider Details

I. General information

NPI: 1578498499
Provider Name (Legal Business Name): DAMEN PATHWAY HEALTH WHEELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 42ND ST S APT 105
FARGO ND
58104-6962
US

IV. Provider business mailing address

3550 42ND ST S APT 105
FARGO ND
58104-6962
US

V. Phone/Fax

Practice location:
  • Phone: 701-290-9156
  • Fax:
Mailing address:
  • Phone: 701-290-9156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS AWUKU
Title or Position: DIRECTOR
Credential: MD
Phone: 701-290-9156