=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962662908
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPHA NURSING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2008
-----------------------------------------------------
Last Update Date | 06/12/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 777 CLEVELAND AVE SW SUITE 306
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30315-7129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-767-6444
-----------------------------------------------------
Fax | 404-676-6444
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 777 CLEVELAND AVE SW SUITE 306
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30315-7129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-767-6444
-----------------------------------------------------
Fax | 404-676-6444
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SAHEET ASHOGBON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-767-6444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------