Provider Demographics
NPI:1679852982
Name:ALLY FRIENDLY TRANSPORTATION
Entity Type:Organization
Organization Name:ALLY FRIENDLY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:I
Authorized Official - Last Name:UMEGBOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-575-6879
Mailing Address - Street 1:4173 MACARTHUR BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-1932
Mailing Address - Country:US
Mailing Address - Phone:510-575-6879
Mailing Address - Fax:
Practice Address - Street 1:4173 MACARTHUR BLVD SUITE 11
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-4360
Practice Address - Country:US
Practice Address - Phone:510-575-6879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28026610343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1518148261Medicare PIN