Provider Demographics
NPI:1669046264
Name:ALPHA MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:ALPHA MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMMADOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-221-3035
Mailing Address - Street 1:7932 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1821
Mailing Address - Country:US
Mailing Address - Phone:281-221-3035
Mailing Address - Fax:312-878-9911
Practice Address - Street 1:7932 DAVIS ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-1821
Practice Address - Country:US
Practice Address - Phone:773-953-3969
Practice Address - Fax:312-878-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)