MEDICARE: PRIME ENTERPRISE ALPHA LLC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1174477160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME ENTERPRISE ALPHA LLC

Provider Business Mailing Address
First Line	:	3685 N IVANHOE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-3726
Country	:	US
Telephone Number	:	813-726-5830
Fax Number	:	813-726-5830

Provider Business Practice Location Address
First Line	:	3685 N IVANHOE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-3726
Country	:	US
Telephone Number	:	813-726-5830
Fax Number	:	813-726-5830

Authorized Official
Title or Position	:	DIRECTOR
Name	:	VIKAS SHARMA
Credential	:	MLT
Telephone Number	:	813-726-5830

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	03/16/2026

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Directions to “PRIME ENTERPRISE ALPHA LLC ” Practice Location

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