Provider Demographics
NPI:1801897384
Name:ALCHEMY PROFESSIONAL SERVICES CORP
Entity type:Organization
Organization Name:ALCHEMY PROFESSIONAL SERVICES CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:951-679-6770
Mailing Address - Street 1:26928 CHERRY HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2505
Mailing Address - Country:US
Mailing Address - Phone:951-679-6512
Mailing Address - Fax:888-870-2519
Practice Address - Street 1:162 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4450
Practice Address - Country:US
Practice Address - Phone:951-658-2505
Practice Address - Fax:951-658-2460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103459332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA103459OtherHMDR
4902050001Medicare ID - Type Unspecified