MEDICARE: FAITH MED LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1831035252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITH MED LLC

Provider Business Mailing Address
First Line	:	2034 EISENHOWER AVE STE 140
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5378
Country	:	US
Telephone Number	:	227-259-4116
Fax Number	:

Provider Business Practice Location Address
First Line	:	2034 EISENHOWER AVE STE 140
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5378
Country	:	US
Telephone Number	:	227-259-4116
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ICHOIKOH WANUKI ACHANGOH
Credential	:
Telephone Number	:	227-259-4116

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “FAITH MED LLC ” Practice Location

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