Provider Demographics
NPI:1629733225
Name:FADI LLC
Entity Type:Organization
Organization Name:FADI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:OCANSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-452-6166
Mailing Address - Street 1:7811 N 155TH ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1824
Mailing Address - Country:US
Mailing Address - Phone:402-452-6166
Mailing Address - Fax:
Practice Address - Street 1:7811 N 155TH ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1824
Practice Address - Country:US
Practice Address - Phone:402-452-6166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)