Provider Demographics
NPI:1326580515
Name:KAMS TRANSPORTATION AND MOBILE HEALTH SERVICES
Entity Type:Organization
Organization Name:KAMS TRANSPORTATION AND MOBILE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANTERPOOL (HODGE)
Authorized Official - Suffix:
Authorized Official - Credentials:A-GNP
Authorized Official - Phone:256-683-1575
Mailing Address - Street 1:102 PEARLE COVE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4243
Mailing Address - Country:US
Mailing Address - Phone:256-947-2285
Mailing Address - Fax:
Practice Address - Street 1:102 PEARLE COVE DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4243
Practice Address - Country:US
Practice Address - Phone:256-947-2285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-06
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207R00000X
AL1-114022363LG0600X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1932163920OtherNPI
AL1245508860OtherNPI