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General NPI Number Information
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NPI Number | 1619106101
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Entity Type | Organization
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Legal Business Name | FRED HANDITRANS SVCS
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 94-1022 HAALAU ST
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City | WAIPAHU
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State | HI
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Zip | 96797-4538
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Country | US
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Telephone | 808-454-7318
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Fax | 808-744-4848
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Provider Business Mailing Address
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Address Line | 94-1022 HAALAU ST
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City | WAIPAHU
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State | HI
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Zip | 96797-4538
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Country | US
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Telephone | 808-454-7318
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Fax | 808-744-4848
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Authorized Official
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Title or Position | OWNER
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Name | MR. FREDULIN UGALE LAZO
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Credential |
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Telephone | 808-454-7318
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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 | 343900000X
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License Number State | HI
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