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General NPI Number Information
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NPI Number | 1457030637
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Entity Type | Organization
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Legal Business Name | FAITH MEDICAL TRANSIT LLC
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 4710 E BROADWAY STE 105
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City | MADISON
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State | WI
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Zip | 53716-4109
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Country | US
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Telephone | 608-598-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 4710 E BROADWAY STE 105
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City | MADISON
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State | WI
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Zip | 53716-4109
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Country | US
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Telephone | 608-598-9950
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FATHI AWIL
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Credential |
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Telephone | 608-598-9959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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