Provider Demographics
NPI:1922563147
Name:ALPHA VASCULAR SCREENINGS LLC
Entity Type:Organization
Organization Name:ALPHA VASCULAR SCREENINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:512-688-0222
Mailing Address - Street 1:190 HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:AL
Mailing Address - Zip Code:35135-1050
Mailing Address - Country:US
Mailing Address - Phone:205-915-8689
Mailing Address - Fax:
Practice Address - Street 1:190 HIGHLAND BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:AL
Practice Address - Zip Code:35135-1050
Practice Address - Country:US
Practice Address - Phone:205-915-8689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory