Provider Demographics
NPI:1699457937
Name:ALPHA CARE SERVICES LLC
Entity type:Organization
Organization Name:ALPHA CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALPHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-450-4800
Mailing Address - Street 1:17425 N 19TH AVE APT 1035
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-2418
Mailing Address - Country:US
Mailing Address - Phone:612-450-4800
Mailing Address - Fax:
Practice Address - Street 1:17425 N 19TH AVE APT 1035
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-2418
Practice Address - Country:US
Practice Address - Phone:612-450-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)