=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881675247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPHA MEDICAL AIDS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2005
-----------------------------------------------------
Last Update Date | 10/28/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3506 SEMINOLE TRAIL ROUTE 29
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22911-8665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-971-7300
-----------------------------------------------------
Fax | 434-971-3739
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3506 SEMINOLE TRAIL ROUTE 29
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22911-8665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-971-7300
-----------------------------------------------------
Fax | 434-710-4033
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/ OWNER
-----------------------------------------------------
Name | MR. 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 |
-----------------------------------------------------