Provider Demographics
NPI:1245862796
Name:ALTIMAMED TRANS SERVICES INC.
Entity type:Organization
Organization Name:ALTIMAMED TRANS SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-505-0102
Mailing Address - Street 1:3304 MCCORKLE CT
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-2327
Mailing Address - Country:US
Mailing Address - Phone:703-505-0102
Mailing Address - Fax:
Practice Address - Street 1:3304 MCCORKLE CT
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-2327
Practice Address - Country:US
Practice Address - Phone:703-505-0102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)