Provider Demographics
NPI:1851083158
Name:OMAA TRANSPORTATION LLC
Entity Type:Organization
Organization Name:OMAA TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OSWALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NKENGURIKIYIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-930-8671
Mailing Address - Street 1:9131 W MINNEZONA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-2446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15381 W MADISON ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-3395
Practice Address - Country:US
Practice Address - Phone:602-930-8671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)