Provider Demographics
NPI:1891524567
Name:KAFEERO, ANDREW (ETC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:KAFEERO
Suffix:
Gender:
Credentials:ETC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SYLVANIA DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2152
Mailing Address - Country:US
Mailing Address - Phone:515-346-4930
Mailing Address - Fax:
Practice Address - Street 1:3201 SYLVANIA DR
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-2152
Practice Address - Country:US
Practice Address - Phone:515-346-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)