Organization
ALPHA&OMEGA HOME AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIRAH JONES MARTIN (AGENCY DIRECTOR)
(336) 724-4701
Entity
Organization
Contact information
Practice address
1001 S MARSHALL ST, BOX 52, WINSTON SALEM, NC 27101-5852
(336) 724-4701
(336) 724-4702
Mailing address
1001 S MARSHALL ST, BOX 52, WINSTON SALEM, NC 27101-5852
(336) 724-4701
(336) 724-4702
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3102
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408597
—
NC
05
—
6601332
—
NC
Enumeration date
03/06/2007
Last updated
08/22/2020
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