Provider Demographics
NPI:1326828062
Name:ALPHA HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:ALPHA HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOROMA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:571-774-2345
Mailing Address - Street 1:13190 CENTERPOINTE WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5286
Mailing Address - Country:US
Mailing Address - Phone:571-774-2345
Mailing Address - Fax:571-552-3147
Practice Address - Street 1:13190 CENTERPOINTE WAY STE 201
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5286
Practice Address - Country:US
Practice Address - Phone:571-774-2345
Practice Address - Fax:571-552-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care