Provider Demographics
NPI:1699257006
Name:AMPO CARE TRANSPORTATION
Entity type:Organization
Organization Name:AMPO CARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMPOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-623-1955
Mailing Address - Street 1:14109 ESTATE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-5824
Mailing Address - Country:US
Mailing Address - Phone:571-623-1955
Mailing Address - Fax:
Practice Address - Street 1:14109 ESTATE MANOR DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-5824
Practice Address - Country:US
Practice Address - Phone:571-623-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)