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General NPI Number Information
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NPI Number | 1679852982
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Entity Type | Organization
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Legal Business Name | ALLY FRIENDLY TRANSPORTATION
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 4173 MACARTHUR BLVD SUITE 11
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City | OAKLAND
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State | CA
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Zip | 94619-4360
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Country | US
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Telephone | 510-575-6879
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Fax |
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Provider Business Mailing Address
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Address Line | 4173 MACARTHUR BLVD STE 11
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City | OAKLAND
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State | CA
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Zip | 94619-1932
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Country | US
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Telephone | 510-575-6879
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALEXANDER I UMEGBOH
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Credential |
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Telephone | 510-575-6879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 28026610
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License Number State | CA
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