Provider Demographics
NPI:1972776821
Name:ALPHA-OMEGA HOSPICE CARE
Entity Type:Organization
Organization Name:ALPHA-OMEGA HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENJI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-278-8585
Mailing Address - Street 1:PO BOX 495998
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-5998
Mailing Address - Country:US
Mailing Address - Phone:972-278-8585
Mailing Address - Fax:214-227-4356
Practice Address - Street 1:3014 S SHILOH RD
Practice Address - Street 2:SUITE D
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-2415
Practice Address - Country:US
Practice Address - Phone:972-278-8585
Practice Address - Fax:214-227-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN/A251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based