Provider Demographics
NPI:1255932679
Name:FAIRFARE LLC
Entity type:Organization
Organization Name:FAIRFARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLMEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-222-9052
Mailing Address - Street 1:25462 ALTA LOMA
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-7014
Mailing Address - Country:US
Mailing Address - Phone:714-222-9052
Mailing Address - Fax:
Practice Address - Street 1:25462 ALTA LOMA
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-7014
Practice Address - Country:US
Practice Address - Phone:714-222-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)