Provider Demographics
NPI:1801261649
Name:ALPHA & OMEGA MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:ALPHA & OMEGA MEDICAL TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LADAWN
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-288-7084
Mailing Address - Street 1:16124 SE COUNTY ROAD 2375
Mailing Address - Street 2:
Mailing Address - City:STREETMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75859-7148
Mailing Address - Country:US
Mailing Address - Phone:903-288-7084
Mailing Address - Fax:903-599-2798
Practice Address - Street 1:16124 SE COUNTY ROAD 2375
Practice Address - Street 2:
Practice Address - City:STREETMAN
Practice Address - State:TX
Practice Address - Zip Code:75859-7148
Practice Address - Country:US
Practice Address - Phone:903-288-7084
Practice Address - Fax:903-599-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)