Provider Demographics
NPI:1275189326
Name:SHADFEM LLC
Entity Type:Organization
Organization Name:SHADFEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FOLASADE
Authorized Official - Middle Name:JULIANA
Authorized Official - Last Name:ODUNSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-701-6488
Mailing Address - Street 1:3511 BRIARWOOD DR UNIT 32
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2123
Mailing Address - Country:US
Mailing Address - Phone:240-701-6488
Mailing Address - Fax:703-634-2954
Practice Address - Street 1:3511 BRIARWOOD DR UNIT 32
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2123
Practice Address - Country:US
Practice Address - Phone:240-701-6488
Practice Address - Fax:703-634-2954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)