Provider Demographics
NPI:1447404413
Name:ALPHA MEDICAL CONTRACTORS
Entity Type:Organization
Organization Name:ALPHA MEDICAL CONTRACTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:PLESHETTE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:404-397-7029
Mailing Address - Street 1:13102 PROVIDENCE CIR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-7138
Mailing Address - Country:US
Mailing Address - Phone:404-397-7029
Mailing Address - Fax:404-366-8102
Practice Address - Street 1:13102 PROVIDENCE CIR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-7138
Practice Address - Country:US
Practice Address - Phone:404-397-7029
Practice Address - Fax:404-366-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN104354251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management