Provider Demographics
NPI:1275964975
Name:ROBERSON REAL ESTATE
Entity Type:Organization
Organization Name:ROBERSON REAL ESTATE
Other - Org Name:ALPHA HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-338-5886
Mailing Address - Street 1:13060 VOLLMER RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-6410
Mailing Address - Country:US
Mailing Address - Phone:719-495-1301
Mailing Address - Fax:
Practice Address - Street 1:13060 VOLLMER RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-6410
Practice Address - Country:US
Practice Address - Phone:719-495-1301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies