1194059717 NPI number — ALTERNATIVE HEALTHCARE SOLUTIONS, INC

Table of content: (NPI 1194059717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194059717 NPI number — ALTERNATIVE HEALTHCARE SOLUTIONS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTERNATIVE HEALTHCARE SOLUTIONS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194059717
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5300 MEMORIAL DR
Provider Second Line Business Mailing Address:
SUITE 201 E & F
Provider Business Mailing Address City Name:
STONE MOUNTAIN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30083-3148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-978-2954
Provider Business Mailing Address Fax Number:
910-488-0585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5300 MEMORIAL DR
Provider Second Line Business Practice Location Address:
SUITE 201 E & F
Provider Business Practice Location Address City Name:
STONE MOUNTAIN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30083-3148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-978-2954
Provider Business Practice Location Address Fax Number:
910-488-0585
Provider Enumeration Date:
09/29/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
AMESHICA
Authorized Official Middle Name:
U
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
910-978-2945

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com