Organization
COUNTYENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FOMBANG (OWNER)
(616) 818-8022
Entity
Organization
Contact information
Practice address
137 N OAK PARK AVE STE 215, OAK PARK, IL 60301-1340
(312) 584-3322
Mailing address
137 N OAK PARK AVE STE 215, OAK PARK, IL 60301-1340
(312) 584-3322
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
07/09/2023
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