Healthcare Provider Details

I. General information

NPI: 1134937444
Provider Name (Legal Business Name): AO MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4997 ELLORA VISTA DR
LAS CRUCES NM
88012-7455
US

IV. Provider business mailing address

1209 MOUNTAIN ROAD PL NE # 5543
ALBUQUERQUE NM
87110-7845
US

V. Phone/Fax

Practice location:
  • Phone: 575-240-7541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JE ANN ADE-OSHIFOGUN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 561-603-2329