Provider Demographics
NPI:1740233329
Name:ALPHA MEDICAL AIDS, INC.
Entity Type:Organization
Organization Name:ALPHA MEDICAL AIDS, INC.
Other - Org Name:ALPHA CONTIN-U-CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBBEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-971-7300
Mailing Address - Street 1:516 PANTOPS CTR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8665
Mailing Address - Country:US
Mailing Address - Phone:434-971-7300
Mailing Address - Fax:434-971-3739
Practice Address - Street 1:1548 JEFFERSON HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2242
Practice Address - Country:US
Practice Address - Phone:434-531-2709
Practice Address - Fax:540-942-5304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA MEDICAL AIDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-18
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA051686OtherANTHEM PROVIDER #
VA224574OtherSOUTHERN HEALTH
VA322965OtherANTHEM MEDIGAP PROVICER #
VA123764OtherSOUTHERN HEALTH PROVIDER
VA224574OtherSOUTHERN HEALTH
VA0206450002Medicare ID - Type UnspecifiedMEDICARE FSH PROVIDER #
VA0206450001Medicare ID - Type UnspecifiedMEDICARE CHV PROVIDER #