NPIMap

Organization Active NPI

Alpha Healthcare LLC

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1134500994
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P06876 Issued in MD
Legal business name
ALPHA HEALTHCARE LLC
Practice address
3061 Frederick Ave
Suite C
Baltimore, MD 21223-2715
Phone
(443) 453-9383
Fax
(443) 453-9483
NPI assigned
Jun 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Clement Adeboye AdebayoNPI 1497193833
Title
Pharmacist/Ceo
Phone
(443) 453-9383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P06876 MD Primary

Addresses

Primary practice location

3061 Frederick Ave
Suite C
Baltimore, MD 21223-2715

Mailing address

3061 Frederick Ave
Suite C
Baltimore, MD 21223-2715
Phone (443) 453-9383

Other names 1

  • alpha pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170315002114 MD Part B Supplier - Mass Immunization (Roster Biller Only) 5395020291 Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Alpha Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1134500994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 FREDERICK AVE",
            "address_2": "SUITE C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232715",
            "telephone_number": "443-453-9383",
            "fax_number": "443-453-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 FREDERICK AVE",
            "address_2": "SUITE C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232715",
            "telephone_number": "443-453-9383",
            "fax_number": "443-453-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "ADEBAYO",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "ADEBOYE",
        "authorized_official_title_or_position": "PHARMACIST/CEO",
        "authorized_official_telephone_number": "443-453-9383",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "alpha pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.