Provider Demographics
NPI:1316760721
Name:FEFELOV TRANS LLC
Entity type:Organization
Organization Name:FEFELOV TRANS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERHII
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-424-0148
Mailing Address - Street 1:100 HAMPDEN DR APT D
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5467
Mailing Address - Country:US
Mailing Address - Phone:321-424-0148
Mailing Address - Fax:
Practice Address - Street 1:100 HAMPDEN DR APT D
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5467
Practice Address - Country:US
Practice Address - Phone:321-424-0618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FEFELOV TRANS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-04
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)