MEDICARE: ALI'S MEDICAL SUPPLY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	326590	OTHER	FL	OXYGEN RETAILER
2	M2840	OTHER	FL	BLUE CROSS BLUE SHIELD
3	1313352	OTHER	FL	AHCA

General Provider Information

NPI Number	:	1235269051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALI'S MEDICAL SUPPLY, INC

Provider Business Mailing Address
First Line	:	6744 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2924
Country	:	US
Telephone Number	:	305-264-9424
Fax Number	:	305-264-9427

Provider Business Practice Location Address
First Line	:	6744 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2924
Country	:	US
Telephone Number	:	305-264-9424
Fax Number	:	305-264-9427

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. AILE RODRIGUEZ
Credential	:
Telephone Number	:	305-264-9424

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	04/15/2008

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