| NPI | 1104686955 |
|---|---|
| Former Legal Business Name | FOMAK TRANSPORTATION,LLC |
| Entity Type | Organization |
| Authorized Contact | DAVID MAHIOKA MBAMBUKULU Owner 319-270-1197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |