Provider Demographics
NPI:1477265494
Name:FANA TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FANA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEMTSHAY
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEBEREGZABHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-275-5381
Mailing Address - Street 1:168 PARIS CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8222
Mailing Address - Country:US
Mailing Address - Phone:720-275-5381
Mailing Address - Fax:
Practice Address - Street 1:168 PARIS CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8222
Practice Address - Country:US
Practice Address - Phone:720-275-5381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)