=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285576066
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAST RELIABLE QUICK LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2026
-----------------------------------------------------
Last Update Date | 04/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 113 1/2 W NORTH ST STE C
-----------------------------------------------------
City | NORMAL
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61761-2587
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-302-9714
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 803 S CENTER ST
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61701-6452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-207-6768
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | QUNSHAWN GARDNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 309-207-6768
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------