Provider Demographics
NPI:1518710367
Name:SERENE NEMT LLC
Entity type:Organization
Organization Name:SERENE NEMT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:SHARDAE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-667-5028
Mailing Address - Street 1:PO BOX 18234
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45018-0234
Mailing Address - Country:US
Mailing Address - Phone:513-667-5028
Mailing Address - Fax:
Practice Address - Street 1:34 PROVIDENCE DR APT 30
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-6653
Practice Address - Country:US
Practice Address - Phone:513-667-5028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)