Organization
MACKMALTER ENTERPRISES INC
Active
Other names
Alpha Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK D CLARK (OWNER)
(618) 438-0309
Entity
Organization
Contact information
Practice address
205 BAILEY LN, BENTON, IL 62812-1921
(618) 438-0309
(618) 438-4406
Mailing address
205 BAILEY LN, BENTON, IL 62812-1921
(618) 438-0309
(618) 438-4406
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
203000212
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02827016
BCBS
IL
01
—
072787
HEALTH ALLIANCE
IL
05
—
200418050A
—
IN
01
—
446436
HEALTHLINK
IL
Enumeration date
07/14/2006
Last updated
04/26/2019
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