Healthcare Provider Details

I. General information

NPI: 1770874760
Provider Name (Legal Business Name): ALPHAFLO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28786 COUNTY ROAD 50
BOVEY MN
55709-5576
US

IV. Provider business mailing address

28786 COUNTY ROAD 50
BOVEY MN
55709-5576
US

V. Phone/Fax

Practice location:
  • Phone: 218-245-2446
  • Fax: 218-245-2802
Mailing address:
  • Phone: 218-245-2446
  • Fax: 218-245-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MARY ALICE HISE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 218-245-2446