Healthcare Provider Details

I. General information

NPI: 1518094218
Provider Name (Legal Business Name): ALPHA CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9312 OLIVE BOULEVARD
ST. LOUIS MO
63132-3208
US

IV. Provider business mailing address

9312 OLIVE BOULEVARD
ST. LOUIS MO
63132-3208
US

V. Phone/Fax

Practice location:
  • Phone: 314-993-2273
  • Fax:
Mailing address:
  • Phone: 314-993-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number761-1
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. GARY L OLSHANSKY
Title or Position: PRESIDENT & CEO
Credential:
Phone: 314-993-2273