Provider Demographics
NPI:1720654155
Name:FREMONT TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FREMONT TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:NOTCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-536-0604
Mailing Address - Street 1:2424 W OAK ST APT 109
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2347
Mailing Address - Country:US
Mailing Address - Phone:940-536-0604
Mailing Address - Fax:
Practice Address - Street 1:2424 W OAK ST APT 109
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2347
Practice Address - Country:US
Practice Address - Phone:940-536-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)