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General NPI Number Information
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NPI Number | 1679076335
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Entity Type | Organization
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Legal Business Name | ALPHA SURGICAL SOLUTIONS LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 7048 OLD CANTON RD STE 220
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City | RIDGELAND
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State | MS
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Zip | 39157-1021
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Country | US
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Telephone | 601-672-3512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1666
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City | MADISON
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State | MS
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Zip | 39130-1666
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Country | US
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Telephone | 601-672-3512
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE A SOSA
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Credential | PA
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Telephone | 601-622-0018
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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 | 16964
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License Number State | MS
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