Healthcare Provider Details

I. General information

NPI: 1558897132
Provider Name (Legal Business Name): ALPHA HOMEHEALTH OF OKC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 NW 57TH ST SUITE 220
OKLAHOMA CITY OK
73112-6814
US

IV. Provider business mailing address

2828 NW 57TH ST SUITE 220
OKLAHOMA CITY OK
73112-6814
US

V. Phone/Fax

Practice location:
  • Phone: 915-848-3505
  • Fax: 405-848-3515
Mailing address:
  • Phone: 915-848-3505
  • Fax: 405-848-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LIONEL TUMA
Title or Position: OWNER
Credential:
Phone: 405-848-3505