MEDICARE: ALPHA MEDICAL TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1477378651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	3700 W SAINT GERMAIN ST APT 202
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-7306
Country	:	US
Telephone Number	:	320-330-9017
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 W SAINT GERMAIN ST APT 202
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-7306
Country	:	US
Telephone Number	:	320-330-9017
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEKA WARSAME
Credential	:
Telephone Number	:	320-330-9017

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/21/2024

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