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NPI Code Detail

MEDICARE: ALFONSO ENTERPRISES

MEDICARE: ALFONSO ENTERPRISES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)332BC3200XGA

General Provider Information

NPI Number : 1053436485
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALFONSO ENTERPRISES
Provider Business Mailing Address
First Line : 2997 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3909
Country : US
Telephone Number : 404-929-9333
Fax Number : 404-929-9890
Provider Business Practice Location Address
First Line : 2997 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3909
Country : US
Telephone Number : 404-929-9333
Fax Number : 404-929-9890
Authorized Official
Title or Position : OWNER
Name : RAUL ALFONSO
Credential :
Telephone Number : 404-929-9333
Provider Enumeration Date : 03/21/2007
Last Update Date : 08/22/2020

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Directions to “ALFONSO ENTERPRISES ” Practice Location

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