Provider Demographics
NPI:1457030637
Name:FAITH MEDICAL TRANSIT LLC
Entity Type:Organization
Organization Name:FAITH MEDICAL TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:AWIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-598-9959
Mailing Address - Street 1:4710 E BROADWAY STE 105
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-4109
Mailing Address - Country:US
Mailing Address - Phone:608-598-9950
Mailing Address - Fax:
Practice Address - Street 1:4710 E BROADWAY STE 105
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-4109
Practice Address - Country:US
Practice Address - Phone:608-598-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company