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General NPI Number Information
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NPI Number | 1306839972
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Entity Type | Organization
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Legal Business Name | ALPHA INC
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 1ST EAST MAIN
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City | CARRINGTON
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State | ND
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Zip | 58421-0261
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Country | US
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Telephone | 701-652-3117
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Fax | 701-652-3118
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Provider Business Mailing Address
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Address Line | PO BOX 261 1ST EAST MAIN
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City | CARRINGTON
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State | ND
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Zip | 58421-0261
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Country | US
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Telephone | 701-652-3117
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Fax | 701-652-3118
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ALLAN METZGER
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Credential |
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Telephone | 701-652-3117
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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 | 1010A
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License Number State | ND
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