Provider Demographics
NPI:1861829285
Name:FAST CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FAST CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMER
Authorized Official - Middle Name:ELHIBER
Authorized Official - Last Name:FADLALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-518-2297
Mailing Address - Street 1:3001 W INDIAN SCHOOL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-4168
Mailing Address - Country:US
Mailing Address - Phone:602-554-8507
Mailing Address - Fax:602-865-7632
Practice Address - Street 1:1724 W LOUGHLIN DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:602-518-2297
Practice Address - Fax:480-248-8631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ699135Medicaid