Provider Demographics
NPI:1881896116
Name:ALPHA OMEGA HEALTH INC.
Entity type:Organization
Organization Name:ALPHA OMEGA HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALIFIED PROFESSIONAL
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:828-649-2367
Mailing Address - Street 1:140 HEALTH CARE LN
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-6350
Mailing Address - Country:US
Mailing Address - Phone:828-649-2367
Mailing Address - Fax:828-649-3859
Practice Address - Street 1:140 HEALTH CARE LN
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-6350
Practice Address - Country:US
Practice Address - Phone:828-649-2367
Practice Address - Fax:828-649-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301778BMedicaid