Provider Demographics
NPI:1972644789
Name:ALPHA MAXX HEALTHCARE INC.
Entity Type:Organization
Organization Name:ALPHA MAXX HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:901-259-5341
Mailing Address - Street 1:2095 EXETER RD
Mailing Address - Street 2:SUITE 80
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3946
Mailing Address - Country:US
Mailing Address - Phone:901-259-5341
Mailing Address - Fax:901-259-5344
Practice Address - Street 1:1407 UNION AVE
Practice Address - Street 2:SUITE 802
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3627
Practice Address - Country:US
Practice Address - Phone:901-259-5341
Practice Address - Fax:901-259-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization