Provider Demographics
NPI:1972702009
Name:ALSTAR MEDICAL TRANSPORTATION INC
Entity type:Organization
Organization Name:ALSTAR MEDICAL TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:TAKPOR
Authorized Official - Last Name:KRUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-353-6081
Mailing Address - Street 1:1943 BENNETT PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4113
Mailing Address - Country:US
Mailing Address - Phone:240-353-6081
Mailing Address - Fax:301-794-0115
Practice Address - Street 1:5509 HILAND AVE
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4721
Practice Address - Country:US
Practice Address - Phone:240-353-6081
Practice Address - Fax:301-794-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1087343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC037691200Medicaid