Healthcare Provider Details

I. General information

NPI: 1255583027
Provider Name (Legal Business Name): ALIMED LABORATORY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 NE 45TH ST
OAKLAND PARK FL
33334-3812
US

IV. Provider business mailing address

1028 NE 45TH ST
OAKLAND PARK FL
33334-3812
US

V. Phone/Fax

Practice location:
  • Phone: 954-771-4155
  • Fax: 954-771-4154
Mailing address:
  • Phone: 954-771-4155
  • Fax: 954-771-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberPH8985
License Number StateFL

VIII. Authorized Official

Name: MRS. SUSAN CAVALIERE
Title or Position: ADMINISTRATOR / PHARMACIST
Credential:
Phone: 954-771-4155