Provider Demographics
NPI:1326584756
Name:THE FREZGHI GROUP LLC
Entity Type:Organization
Organization Name:THE FREZGHI GROUP LLC
Other - Org Name:RED SEA TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEAZA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBREAMLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-304-1201
Mailing Address - Street 1:1701 COUNTRY CLUB DR NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-4808
Mailing Address - Country:US
Mailing Address - Phone:616-304-1201
Mailing Address - Fax:
Practice Address - Street 1:1701 COUNTRY CLUB DR NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-4808
Practice Address - Country:US
Practice Address - Phone:616-304-1201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIG165599288056343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)