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General NPI Number Information
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NPI Number | 1144360348
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Entity Type | Organization
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Legal Business Name | ALAMO FIESTA MEDICAL SUPPLY
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 1040 WEST ELLIS
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City | ALAMO
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State | TX
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Zip | 78516-2593
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Country | US
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Telephone | 956-702-1848
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Fax | 956-702-1852
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Provider Business Mailing Address
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Address Line | BOX 3716
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City | ALAMO
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State | TX
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Zip | 78516
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Country | US
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Telephone | 956-702-1848
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Fax | 956-702-1852
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Authorized Official
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Title or Position | OWNER
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Name | JULIETA QUIRINO
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Credential |
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Telephone | 956-702-2167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0076352
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License Number State | TX
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