Provider Demographics
NPI:1073127023
Name:FED LLC
Entity Type:Organization
Organization Name:FED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:OGAGAWORDIA
Authorized Official - Last Name:BIOKORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-779-1280
Mailing Address - Street 1:1446 W 94TH CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2217
Mailing Address - Country:US
Mailing Address - Phone:219-779-1280
Mailing Address - Fax:
Practice Address - Street 1:1446 W 94TH CT
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-2217
Practice Address - Country:US
Practice Address - Phone:219-779-1280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-06
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle