Provider Demographics
NPI:1679275606
Name:FAB'S FAMILY MEDICAL TRANSPORT, LLC
Entity type:Organization
Organization Name:FAB'S FAMILY MEDICAL TRANSPORT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:BETHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-770-7159
Mailing Address - Street 1:239 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4940
Mailing Address - Country:US
Mailing Address - Phone:434-770-7159
Mailing Address - Fax:800-819-8339
Practice Address - Street 1:239 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4940
Practice Address - Country:US
Practice Address - Phone:434-770-7159
Practice Address - Fax:800-819-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport