Provider Demographics
NPI:1750568309
Name:ALPHA MEDICAL EVALUATIONS, LLC
Entity type:Organization
Organization Name:ALPHA MEDICAL EVALUATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-255-9870
Mailing Address - Street 1:PO BOX 19187
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73144-0187
Mailing Address - Country:US
Mailing Address - Phone:405-255-9870
Mailing Address - Fax:405-680-5076
Practice Address - Street 1:2 S COO Y YAH ST
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-4636
Practice Address - Country:US
Practice Address - Phone:405-255-9870
Practice Address - Fax:405-680-5076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty