Provider Demographics
NPI:1417409905
Name:ALPHA CARE MEDICAL, LLC
Entity type:Organization
Organization Name:ALPHA CARE MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-818-8680
Mailing Address - Street 1:1340 MIDDLEFORD RD STE 401
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3665
Mailing Address - Country:US
Mailing Address - Phone:302-567-8056
Mailing Address - Fax:866-229-0237
Practice Address - Street 1:1340 MIDDLEFORD RD STE 401
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3665
Practice Address - Country:US
Practice Address - Phone:800-818-8680
Practice Address - Fax:866-229-0237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 207Q00000X, 261QP3300X
DEC1-0011360261QP2300X, 261QM0850X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250027856Medicaid