Provider Demographics
NPI:1942233226
Name:ALPHA-MK HEALTHCARE, INC
Entity Type:Organization
Organization Name:ALPHA-MK HEALTHCARE, INC
Other - Org Name:ALPHA-MK HEALTHCARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANYANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-351-5558
Mailing Address - Street 1:509 CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8968
Mailing Address - Country:US
Mailing Address - Phone:214-351-5558
Mailing Address - Fax:214-351-5559
Practice Address - Street 1:509 CREEK CT
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8968
Practice Address - Country:US
Practice Address - Phone:214-351-5558
Practice Address - Fax:214-351-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010462251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010462OtherSTATE LICENSE NUMBER