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General NPI Number Information
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NPI Number | 1275338899
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Entity Type | Organization
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Legal Business Name | IFAA,LLC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 721 S 6 1/2 ST UNIT 1
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City | PARAGOULD
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State | AR
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Zip | 72450-5006
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Country | US
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Telephone | 870-215-9731
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Fax |
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Provider Business Mailing Address
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Address Line | 721 S 6 1/2 ST UNIT 1
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City | PARAGOULD
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State | AR
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Zip | 72450-5006
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Country | US
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Telephone | 870-215-9731
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ABDUREZAK OMER
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Credential |
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Telephone | 870-215-9731
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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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