Organization
ALPHA HSS, INC
Active
Other names
Alphatelemed
Organization subpart
No
Provider details
NPI number
Authorized official
MUBIN JIWANI (PRESIDENT)
(703) 589-9964
Entity
Organization
Contact information
Practice address
103 RANDOLPH AVE # 212, ELKINS, WV 26241-4067
(703) 589-9964
Mailing address
10622 RUNAWAY LN, GREAT FALLS, VA 22066-2420
(703) 589-9964
(571) 252-7100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871007377
—
FL
05
—
1992340970
—
VA
Enumeration date
09/11/2023
Last updated
09/11/2023
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