Provider Demographics
NPI:1053498477
Name:ALPHA-MED HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ALPHA-MED HOME HEALTH SERVICES, INC.
Other - Org Name:ALPHA-MED HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-313-0080
Mailing Address - Street 1:2855 MANGUM RD STE 401
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7486
Mailing Address - Country:US
Mailing Address - Phone:281-313-0080
Mailing Address - Fax:281-313-0255
Practice Address - Street 1:2855 MANGUM RD STE 401
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7486
Practice Address - Country:US
Practice Address - Phone:281-313-0080
Practice Address - Fax:281-313-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009862251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679500Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER