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General NPI Number Information
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NPI Number | 1891873683
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Entity Type | Organization
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Legal Business Name | ALPHA CARE CORPORATION
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 4813 MACCORKLE AVE SE
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City | CHARLESTON
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State | WV
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Zip | 25304-1948
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Country | US
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Telephone | 304-720-2017
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Fax | 304-720-0888
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Provider Business Mailing Address
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Address Line | PO BOX 4047
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City | CHARLESTON
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State | WV
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Zip | 25364-4047
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Country | US
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Telephone | 304-720-2017
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Fax | 304-720-0888
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. GAI LOUISE SMYTHE
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Credential | M.D.
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Telephone | 304-720-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 20569
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License Number State | WV
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