Provider Demographics
NPI:1598191264
Name:ALPHA HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ALPHA HEALTHCARE SERVICES INC
Other - Org Name:UNITED HOME HEALTH CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLIVE
Authorized Official - Middle Name:N
Authorized Official - Last Name:FOKUMLAH
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:405-675-7478
Mailing Address - Street 1:7004 NW 63RD ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-1952
Mailing Address - Country:US
Mailing Address - Phone:405-675-7478
Mailing Address - Fax:405-506-0910
Practice Address - Street 1:7004 NW 63RD ST STE 103
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-1952
Practice Address - Country:US
Practice Address - Phone:405-675-7478
Practice Address - Fax:405-506-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC8023251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHC8023Medicaid