MEDICARE: ALFA TELECOM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1003649781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFA TELECOM

Provider Business Mailing Address
First Line	:	6121 LINCOLNIA RD STE 106
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2707
Country	:	US
Telephone Number	:	703-751-2532
Fax Number	:

Provider Business Practice Location Address
First Line	:	6121 LINCOLNIA RD STE 106
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312-2707
Country	:	US
Telephone Number	:	703-751-2532
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEMAYEHU ALEMU
Credential	:
Telephone Number	:	703-751-2532

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	08/20/2024

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Directions to “ALFA TELECOM ” Practice Location

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