Provider Demographics
NPI:1801234067
Name:ALT RESOURCES LLC
Entity type:Organization
Organization Name:ALT RESOURCES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:OSARHUMWENSE
Authorized Official - Last Name:UKPEDINJAGBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-556-9302
Mailing Address - Street 1:1005 S TELSHOR BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4879
Mailing Address - Country:US
Mailing Address - Phone:575-556-9302
Mailing Address - Fax:575-556-9314
Practice Address - Street 1:1005 S TELSHOR BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4879
Practice Address - Country:US
Practice Address - Phone:575-556-9302
Practice Address - Fax:575-556-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM55953343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)