Fountain Medical Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

FOUNTAIN MEDICAL TRANSPORT LLC

Practice address

1727 King St Ste 137
Alexandria, VA 22314-2761

Phone

(304) 919-0667

NPI assigned

May 2, 2020

Last updated

May 2, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fidel Nwazuzu

Title

Owern

Phone

(304) 919-0667

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588377600000",
    "number": "1649891425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 KING ST STE 137",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142761",
            "telephone_number": "304-919-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 KING ST STE 137",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142761",
            "telephone_number": "304-919-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN MEDICAL TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-02",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A",
        "authorized_official_last_name": "NWAZUZU",
        "authorized_official_first_name": "FIDEL",
        "authorized_official_title_or_position": "OWERN",
        "authorized_official_telephone_number": "304-919-0667"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mariya Fox-Rabinovich, MA, RD, LDN, CDCES
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• Non-emergency Medical Transport (VAN) in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.