Provider Demographics
NPI:1548229339
Name:ALPHA OMEGA HOME HEALTH, LLC
Entity type:Organization
Organization Name:ALPHA OMEGA HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:SRAJ
Authorized Official - Last Name:SOPKO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:989-375-4444
Mailing Address - Street 1:120 MULLEN ST
Mailing Address - Street 2:P.O. BOX 127
Mailing Address - City:ELKTON
Mailing Address - State:MI
Mailing Address - Zip Code:48731-5156
Mailing Address - Country:US
Mailing Address - Phone:989-375-4444
Mailing Address - Fax:989-375-4409
Practice Address - Street 1:120 MULLEN ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MI
Practice Address - Zip Code:48731-5156
Practice Address - Country:US
Practice Address - Phone:989-375-4444
Practice Address - Fax:989-375-4409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-7591Medicare ID - Type Unspecified