Organization
DIRECT ALPHA HEALTH CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J B TATE (PRESIDENT)
(708) 283-2511
Entity
Organization
Contact information
Practice address
19900 GOVERNORS DR STE 16, OLYMPIA FIELDS, IL 60461-1059
(708) 283-2511
Mailing address
19900 GOVERNORS DR STE 16, OLYMPIA FIELDS, IL 60461-1059
(708) 283-2511
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
004.002239
IL
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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