MEDICARE: ALPHA MEDICAL CENTER, PA

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	207R00000X	Internal Medicine Physician	9901274	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1246H	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285719997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA MEDICAL CENTER, PA

Provider Business Mailing Address
First Line	:	PO BOX 1689
Second Line	:
City	:	ETOWAH
State	:	NC
Zip	:	28729-1689
Country	:	US
Telephone Number	:	828-891-5524
Fax Number	:	828-891-4069

Provider Business Practice Location Address
First Line	:	1815 FORT BRAGG RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-6804
Country	:	US
Telephone Number	:	910-221-3300
Fax Number	:	910-221-3302

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BABATUNDE OJO
Credential	:	MD
Telephone Number	:	910-221-3300

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/13/2009

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Directions to “ALPHA MEDICAL CENTER, PA ” Practice Location

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