Healthcare Provider Details

I. General information

NPI: 1831529817
Provider Name (Legal Business Name): ALPHA MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 MERRICK RD
ROCKVILLE CTR NY
11570-5491
US

IV. Provider business mailing address

505 MERRICK RD
ROCKVILLE CTR NY
11570-5491
US

V. Phone/Fax

Practice location:
  • Phone: 718-496-9476
  • Fax: 516-945-0906
Mailing address:
  • Phone: 718-496-9476
  • Fax: 516-945-0906

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: YURIS PAULA
Title or Position: OWNER
Credential:
Phone: 718-496-9476