Healthcare Provider Details

I. General information

NPI: 1093545766
Provider Name (Legal Business Name): FASTWIFI COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 12TH ST STE 1
DUNBAR WV
25064-3012
US

IV. Provider business mailing address

1604 VIRGINIA AVE
DUNBAR WV
25064-2423
US

V. Phone/Fax

Practice location:
  • Phone: 304-807-2571
  • Fax:
Mailing address:
  • Phone: 304-807-2571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: WENLY BELIARD
Title or Position: EXECUTIVE DIRECTOR/OWNER
Credential:
Phone: 304-807-2571