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Organization
ALPHA HOME CARE LLC
Active
Organization
ALPHA HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TUMIKO RUCKER MBA (ADMINISTRATOR)
(843) 779-0572
Entity
Organization
Contact information
Practice address
2826 SUMMERTREES BLVD, JOHNS ISLAND, SC 29455-3909
(843) 224-1624
(843) 779-0572
Mailing address
PO BOX 1689, JOHNS ISLAND, SC 29457-1689
(843) 224-1624
(843) 779-0572
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHCP-0970
SC DHEC LICENSE
SC
Enumeration date
12/17/2018
Last updated
06/11/2019
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