MEDICARE: ALFA HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1609022235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFA HEALTHCARE

Provider Business Mailing Address
First Line	:	1112 S WASHINGTON ST STE 15
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-7999
Country	:	US
Telephone Number	:	630-778-2005
Fax Number	:	630-778-2006

Provider Business Practice Location Address
First Line	:	1112 S WASHINGTON ST STE 15
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-7999
Country	:	US
Telephone Number	:	630-778-2005
Fax Number	:	630-778-2006

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LIDIA KOLARIKOVA
Credential	:
Telephone Number	:	630-778-2005

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	08/14/2008

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