Provider Demographics
NPI:1255646188
Name:OMEGA TRANSPORTATION SERVICES, LLC
Entity type:Organization
Organization Name:OMEGA TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRYLE
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:FARRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-245-5543
Mailing Address - Street 1:6818 BLACKSTONE PL
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5441
Mailing Address - Country:US
Mailing Address - Phone:404-245-5543
Mailing Address - Fax:770-944-9576
Practice Address - Street 1:6818 BLACKSTONE PL
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5441
Practice Address - Country:US
Practice Address - Phone:404-245-5543
Practice Address - Fax:770-944-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)