Provider Demographics
NPI:1932822541
Name:FZIW LLC
Entity Type:Organization
Organization Name:FZIW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KADIRATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRIGNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-805-0662
Mailing Address - Street 1:1010 N BELL ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4347
Mailing Address - Country:US
Mailing Address - Phone:402-620-6673
Mailing Address - Fax:402-620-6676
Practice Address - Street 1:1010 N BELL ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-4347
Practice Address - Country:US
Practice Address - Phone:402-620-6673
Practice Address - Fax:402-620-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE92141460Medicaid