Provider Demographics
NPI:1811706989
Name:FREKAM MOBILITY SERVICES LLC
Entity type:Organization
Organization Name:FREKAM MOBILITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAMBUNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-568-8106
Mailing Address - Street 1:11820 BLUE SPRUCE CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-4100
Mailing Address - Country:US
Mailing Address - Phone:763-568-8106
Mailing Address - Fax:
Practice Address - Street 1:11820 BLUE SPRUCE CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:MN
Practice Address - Zip Code:55327-4100
Practice Address - Country:US
Practice Address - Phone:763-568-8106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)