Healthcare Provider Details

I. General information

NPI: 1316712185
Provider Name (Legal Business Name): FASTRAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 STOCKWELL DR
MURFREESBORO TN
37128-3883
US

IV. Provider business mailing address

1216 STOCKWELL DR
MURFREESBORO TN
37128-3883
US

V. Phone/Fax

Practice location:
  • Phone: 615-207-1493
  • Fax:
Mailing address:
  • Phone: 615-207-1493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: FASIKA G GEBREMARIAM
Title or Position: OWENER
Credential:
Phone: 615-207-1493