Provider Demographics
NPI:1104306752
Name:AMA INTERPRIZE
Entity type:Organization
Organization Name:AMA INTERPRIZE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARLANDERS
Authorized Official - Middle Name:MYRON
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OTHER
Authorized Official - Phone:916-283-1240
Mailing Address - Street 1:6780 GLORIA DR APT 30
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-2054
Mailing Address - Country:US
Mailing Address - Phone:916-283-1240
Mailing Address - Fax:
Practice Address - Street 1:6780 GLORIA DR APT 30
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-2054
Practice Address - Country:US
Practice Address - Phone:191-628-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)