Healthcare Provider Details

I. General information

NPI: 1467024984
Provider Name (Legal Business Name): ALPHA CARE MEDICAL EQUIPMENT AND SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 E 6TH ST APT 4B
NEW YORK NY
10009-6667
US

IV. Provider business mailing address

532 E 6TH ST APT 4B
NEW YORK NY
10009-6667
US

V. Phone/Fax

Practice location:
  • Phone: 917-294-0681
  • Fax:
Mailing address:
  • Phone: 917-294-0681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: PHILIPPE MEDINA
Title or Position: C.E.O
Credential:
Phone: 917-294-0681