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General NPI Number Information
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NPI Number | 1093631806
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Entity Type | Organization
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Legal Business Name | HIS FAITH DRIVERS, LLC
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 715 MINER DR APT C3
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City | MEDINA
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State | OH
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Zip | 44256-1438
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Country | US
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Telephone | 330-298-5469
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Fax | 330-298-5469
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Provider Business Mailing Address
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Address Line | 715 MINER DR APT C3
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City | MEDINA
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State | OH
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Zip | 44256-1438
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Country | US
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Telephone | 330-298-5469
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Fax | 330-298-5469
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Authorized Official
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Title or Position | CEO/MANAGING PARTNER
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Name | CARLA ANNE MCKISSACK
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Credential |
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Telephone | 330-298-5469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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