MEDICARE: ALPHA OMEGA HEALTH, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	251S00000X	Community/Behavioral Health Agency
3	253J00000X	Foster Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629195706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA OMEGA HEALTH, INC.

Provider Business Mailing Address
First Line	:	5950 SIX FORKS RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-3895
Country	:	US
Telephone Number	:	919-844-1008
Fax Number	:

Provider Business Practice Location Address
First Line	:	2421 CHARLES BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5925
Country	:	US
Telephone Number	:	252-413-0611
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN K HORNE JR.
Credential	:
Telephone Number	:	919-844-1008

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	12/29/2009

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Directions to “ALPHA OMEGA HEALTH, INC. ” Practice Location

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