MEDICARE: ALPHA HEALTHCARE SERVICES, LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1841767050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 483
Second Line	:
City	:	BRICE
State	:	OH
Zip	:	43109-0483
Country	:	US
Telephone Number	:	614-804-5488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2244 S HAMILTON RD STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4390
Country	:	US
Telephone Number	:	614-804-5488
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VIDA KANKAM
Credential	:
Telephone Number	:	614-804-5488

Provider Enumeration Date	:	10/25/2018
Last Update Date	:	02/07/2022

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Directions to “ALPHA HEALTHCARE SERVICES, LLC ” Practice Location

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