=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740233329
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPHA MEDICAL AIDS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2006
-----------------------------------------------------
Last Update Date | 08/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1548 JEFFERSON HWY SUITE 2
-----------------------------------------------------
City | FISHERSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22939-2242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-531-2709
-----------------------------------------------------
Fax | 540-942-5304
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 516 PANTOPS CTR
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22911-8665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-971-7300
-----------------------------------------------------
Fax | 434-971-3739
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | EBBEN C DEATON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 434-971-7300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------