Provider Demographics
NPI:1538946181
Name:ALPHA CARE
Entity type:Organization
Organization Name:ALPHA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/APN
Authorized Official - Prefix:
Authorized Official - First Name:TSION
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMO
Authorized Official - Suffix:
Authorized Official - Credentials:APN, AGCNS-BC
Authorized Official - Phone:720-327-9967
Mailing Address - Street 1:6105 S MAIN ST SUITE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5361
Mailing Address - Country:US
Mailing Address - Phone:720-327-9967
Mailing Address - Fax:720-783-2812
Practice Address - Street 1:445 S LANSING ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2207
Practice Address - Country:US
Practice Address - Phone:720-327-9967
Practice Address - Fax:303-994-6503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty