Provider Demographics
NPI:1215469168
Name:ALPHA & OMEGA TRANSPORTATION
Entity type:Organization
Organization Name:ALPHA & OMEGA TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHADY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:337-515-1491
Mailing Address - Street 1:12011 BRICKSON AVE.
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2339
Mailing Address - Country:US
Mailing Address - Phone:337-515-1491
Mailing Address - Fax:
Practice Address - Street 1:12011 BRICKSOME AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2339
Practice Address - Country:US
Practice Address - Phone:337-515-1491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)