Healthcare Provider Details

I. General information

NPI: 1841456746
Provider Name (Legal Business Name): ALTERNATIVE MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 04/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 FRONT AVE NW SUITE 135
GRAND RAPIDS MI
49504-5325
US

IV. Provider business mailing address

678 FRONT AVE NW SUITE 135
GRAND RAPIDS MI
49504-5325
US

V. Phone/Fax

Practice location:
  • Phone: 606-451-4000
  • Fax:
Mailing address:
  • Phone: 606-451-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD ORTEGA
Title or Position: PRESIDENT
Credential:
Phone: 616-451-4000