Provider Demographics
NPI:1598122624
Name:ALPHA & OMEGA MEDICAL LLC
Entity Type:Organization
Organization Name:ALPHA & OMEGA MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-739-0155
Mailing Address - Street 1:497 STATE ROAD 436 STE 155
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4905
Mailing Address - Country:US
Mailing Address - Phone:941-739-0155
Mailing Address - Fax:727-245-8442
Practice Address - Street 1:497 STATE ROAD 436 STE 155
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-4905
Practice Address - Country:US
Practice Address - Phone:941-739-0155
Practice Address - Fax:727-245-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies