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NPI Code Detail

MEDICARE: ALPHA CARE MEDICAL SUPPLY, INC.

MEDICARE: ALPHA CARE MEDICAL SUPPLY, INC.
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
1332B00000XDurable Medical Equipment & Medical SuppliesSR AA 101-643123CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SR AA 101-643123OTHERCACA STATE BOARD OF EQUALIZATION

General Provider Information

NPI Number : 1215246228
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA CARE MEDICAL SUPPLY, INC.
Provider Business Mailing Address
First Line : 21235 S WILMINGTON AVE
Second Line : SUITE 6
City : LONG BEACH
State : CA
Zip : 90810-1200
Country : US
Telephone Number : 310-847-7070
Fax Number : 310-847-7171
Provider Business Practice Location Address
First Line : 21235 S WILMINGTON AVE
Second Line : SUITE 6
City : LONG BEACH
State : CA
Zip : 90810-1200
Country : US
Telephone Number : 310-847-7070
Fax Number : 310-847-7171
Authorized Official
Title or Position : MANAGING DIRECTOR
Name : MRS. CHIOMA ORANU
Credential :
Telephone Number : 310-847-7070
Provider Enumeration Date : 09/26/2010
Last Update Date : 09/26/2010

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