Provider Demographics
NPI:1275338899
Name:IFAA,LLC
Entity type:Organization
Organization Name:IFAA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUREZAK
Authorized Official - Middle Name:
Authorized Official - Last Name:OMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-215-9731
Mailing Address - Street 1:721 S 6 1/2 ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5006
Mailing Address - Country:US
Mailing Address - Phone:870-215-9731
Mailing Address - Fax:
Practice Address - Street 1:721 S 6 1/2 ST UNIT 1
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5006
Practice Address - Country:US
Practice Address - Phone:870-215-9731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)