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General NPI Number Information
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NPI Number | 1154783074
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Entity Type | Organization
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Legal Business Name | ALPHA MEDICAL LABORATORY LLC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2448 E 81ST ST STE 4000
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City | TULSA
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State | OK
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Zip | 74137-4300
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Country | US
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Telephone | 918-983-0944
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Fax | 918-399-9098
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Provider Business Mailing Address
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Address Line | 2448 E 81ST ST STE 4000
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City | TULSA
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State | OK
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Zip | 74137-4300
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Country | US
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Telephone | 918-398-0944
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Fax | 918-939-9098
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. ROBERT E GATES
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Credential |
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Telephone | 918-949-5544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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