=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730361411
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPHAMED, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2007
-----------------------------------------------------
Last Update Date | 08/27/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 557 PICKWICK ST
-----------------------------------------------------
City | SAVANNAH
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38372-3082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-925-5534
-----------------------------------------------------
Fax | 731-925-5926
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 10728
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38308-0112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-925-5534
-----------------------------------------------------
Fax | 731-925-5926
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CEO
-----------------------------------------------------
Name | MR. DAVID B SCOTT
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 731-660-0060
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0000000913
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------