Provider Demographics
NPI:1548552870
Name:ALPHA HOMECARE HOSPICE INC.
Entity type:Organization
Organization Name:ALPHA HOMECARE HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-400-3073
Mailing Address - Street 1:230 NORTH 1680 EAST
Mailing Address - Street 2:SUITE E-2
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2625
Mailing Address - Country:US
Mailing Address - Phone:435-628-2500
Mailing Address - Fax:435-628-2575
Practice Address - Street 1:230 NORTH 1680 EAST
Practice Address - Street 2:SUITE E-2
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2625
Practice Address - Country:US
Practice Address - Phone:435-628-2500
Practice Address - Fax:435-628-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
UT2012-HOSPICE102444251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based