Healthcare Provider Details

I. General information

NPI: 1538946181
Provider Name (Legal Business Name): ALPHA CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 S LANSING ST
AURORA CO
80012-2207
US

IV. Provider business mailing address

6105 S MAIN ST SUITE 200
AURORA CO
80016-5361
US

V. Phone/Fax

Practice location:
  • Phone: 720-327-9967
  • Fax: 303-994-6503
Mailing address:
  • Phone: 720-327-9967
  • Fax: 720-783-2812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TSION MAMO
Title or Position: OWNER/APN
Credential: APN, AGCNS-BC
Phone: 720-327-9967