1992015432 NPI number — ALPHA HOME CARE SERVICES, INC. III

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992015432 NPI number — ALPHA HOME CARE SERVICES, INC. III

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALPHA HOME CARE SERVICES, INC. III
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:
1992015432
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 41153
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-819-3882
Provider Business Mailing Address Fax Number:
347-521-2471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3716 ARROWWOOD DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-819-3882
Provider Business Practice Location Address Fax Number:
347-521-2471
Provider Enumeration Date:
10/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
OKWOSHAH
Authorized Official First Name:
JULIET
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
919-819-3882

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: MHL-092-791 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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