Provider Demographics
NPI:1346774114
Name:FOM TRANSPORTATION INC
Entity Type:Organization
Organization Name:FOM TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIUD
Authorized Official - Middle Name:NJERU
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-296-0246
Mailing Address - Street 1:29 CUMMINGS PARK
Mailing Address - Street 2:SUITE 422
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2156
Mailing Address - Country:US
Mailing Address - Phone:774-296-0246
Mailing Address - Fax:857-999-3911
Practice Address - Street 1:29 CUMMINGS PARK
Practice Address - Street 2:SUITE 422
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2156
Practice Address - Country:US
Practice Address - Phone:774-296-0246
Practice Address - Fax:857-999-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)