=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366272965
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPHAFORCE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2024
-----------------------------------------------------
Last Update Date | 08/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7408 CAMBRIDGE PL
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46123-5685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 463-336-3843
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7408 CAMBRIDGE PL
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46123-5685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 463-336-3843
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPERATIONS MANAGER
-----------------------------------------------------
Name | MR. BANKOLE W ADEIGBE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 463-336-3843
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------