Provider Demographics
NPI:1861199051
Name:FOBBS AMIABLE CARE TRANSPORT ETC LLC
Entity type:Organization
Organization Name:FOBBS AMIABLE CARE TRANSPORT ETC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMAINE
Authorized Official - Middle Name:JARVEZ
Authorized Official - Last Name:FOBBS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:252-557-5505
Mailing Address - Street 1:1528 BRIAR GLENN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-8103
Mailing Address - Country:US
Mailing Address - Phone:252-557-5505
Mailing Address - Fax:
Practice Address - Street 1:1528 BRIAR GLENN RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8103
Practice Address - Country:US
Practice Address - Phone:252-557-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle