Healthcare Provider Details

I. General information

NPI: 1063431187
Provider Name (Legal Business Name): A&L MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4123 NORTH STATE RD 7
LAUDERDALE LAKES FL
33319
US

IV. Provider business mailing address

4123 NORTH STATE RD 7
LAUDERDALE LAKES FL
33319
US

V. Phone/Fax

Practice location:
  • Phone: 954-484-5227
  • Fax: 954-484-1503
Mailing address:
  • Phone: 954-484-5227
  • Fax: 954-484-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAHCA1312707
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3202745
License Number StateFL

VIII. Authorized Official

Name: WILKEN L TISDALE
Title or Position: PRESIDENT
Credential:
Phone: 954-484-5227