Provider Demographics
NPI:1316186695
Name:ALPHA MEDICAL CARE SERVICES LLC
Entity Type:Organization
Organization Name:ALPHA MEDICAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILVIDSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-696-0926
Mailing Address - Street 1:1111 RIVER RD
Mailing Address - Street 2:SUITE B14
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1335
Mailing Address - Country:US
Mailing Address - Phone:201-696-0926
Mailing Address - Fax:
Practice Address - Street 1:1111 RIVER RD
Practice Address - Street 2:SUITE B14
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1335
Practice Address - Country:US
Practice Address - Phone:201-696-0926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory