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General NPI Number Information
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NPI Number | 1528842705
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Entity Type | Organization
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Legal Business Name | ALPHA ONE HOME MEALS
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 1 WHILLER DR
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City | GREENVILLE
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State | SC
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Zip | 29605-3680
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Country | US
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Telephone | 864-631-1208
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Fax | 864-631-1203
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Provider Business Mailing Address
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Address Line | 1 WHILLER DR
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City | GREENVILLE
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State | SC
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Zip | 29605-3680
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Country | US
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Telephone | 864-631-1208
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | STEPHON B GARY
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Credential |
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Telephone | 864-631-1208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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