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General NPI Number Information
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NPI Number | 1851539324
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Entity Type | Organization
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Legal Business Name | ALEGRIA PHANKONSY FREEMOTION PLUS MEDICAL SUPPLY
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 501 S RANCHO DR STE A1 A1
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City | LAS VEGAS
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State | NV
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Zip | 89106-4829
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Country | US
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Telephone | 702-982-3859
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Fax | 702-982-1601
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Provider Business Mailing Address
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Address Line | 501 S RANCHO DR STE A1 A1 A2
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City | LAS VEGAS
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State | NV
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Zip | 89106-4829
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Country | US
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Telephone | 702-982-3859
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Fax | 702-982-1601
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Authorized Official
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Title or Position | OWNER
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Name | ALEGRIA PHANKONSY
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Credential |
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Telephone | 702-982-3859
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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 |
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License Number State |
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