Provider Demographics
NPI:1164872628
Name:FM MOBILITY CARE
Entity Type:Organization
Organization Name:FM MOBILITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMSES
Authorized Official - Middle Name:
Authorized Official - Last Name:YANNARODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-306-3360
Mailing Address - Street 1:1336 25TH AVE S STE 213
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5202
Mailing Address - Country:US
Mailing Address - Phone:701-235-5450
Mailing Address - Fax:701-325-2338
Practice Address - Street 1:1336 25TH AVE S STE 213
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5202
Practice Address - Country:US
Practice Address - Phone:701-235-5450
Practice Address - Fax:701-325-2338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)