Provider Demographics
NPI:1134984826
Name:FAMILY CARE TRANSPORTATION INC
Entity type:Organization
Organization Name:FAMILY CARE TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TARIKU
Authorized Official - Middle Name:TESFAYE
Authorized Official - Last Name:KEBEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-616-8942
Mailing Address - Street 1:215 W MACARTHUR BLVD APT 249
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5307
Mailing Address - Country:US
Mailing Address - Phone:510-219-6050
Mailing Address - Fax:
Practice Address - Street 1:66 FRANKLIN ST STE 300
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3734
Practice Address - Country:US
Practice Address - Phone:510-616-8942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle