1326172057 NPI number — ALPHA SERVICE INDUSTRIES, INC.

Table of content: (NPI 1326172057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326172057 NPI number — ALPHA SERVICE INDUSTRIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALPHA SERVICE INDUSTRIES, 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:
6
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:
1326172057
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 NICOLLET MALL
Provider Second Line Business Mailing Address:
STE 1050
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55402-2624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-333-8001
Provider Business Mailing Address Fax Number:
651-925-0267

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 NICOLLET MALL
Provider Second Line Business Practice Location Address:
STE 1050
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55402-2624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-333-8001
Provider Business Practice Location Address Fax Number:
651-925-0267
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HEISEL
Authorized Official First Name:
SARA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
763-333-8001

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8465104 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8465108 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: OG152AL . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8465105 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8G482AL . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: OG158AL . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8465106 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8565107 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8465103 . This is a "UBH" identifier . This identifiers is of the category "OTHER".




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