Healthcare Provider Details

I. General information

NPI: 1922491232
Provider Name (Legal Business Name): ALPHA TELEHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3380 ERIE AVE SUITE 240
CINCINNATI OH
45208-1626
US

IV. Provider business mailing address

3380 ERIE AVE SUITE 240
CINCINNATI OH
45208-1626
US

V. Phone/Fax

Practice location:
  • Phone: 513-334-0073
  • Fax:
Mailing address:
  • Phone: 513-334-0073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number35043909
License Number StateOH

VIII. Authorized Official

Name: DR. JOSE LUIS CHAVEZ
Title or Position: PRESIDAENT
Credential: M.D.
Phone: 513-334-0073