Healthcare Provider Details

I. General information

NPI: 1154924603
Provider Name (Legal Business Name): FULANI SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 GORGE BLVD
AKRON OH
44310-3462
US

IV. Provider business mailing address

877 GORGE BLVD
AKRON OH
44310-3462
US

V. Phone/Fax

Practice location:
  • Phone: 234-303-9210
  • Fax:
Mailing address:
  • Phone: 234-303-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: ALPHA M SOUARE
Title or Position: CEO
Credential:
Phone: 234-303-9210