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NPI Code Detail

MEDICARE: ALLIANCE MED SUPPLY LLC

MEDICARE: ALLIANCE MED SUPPLY 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1407797772
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE MED SUPPLY LLC
Provider Business Mailing Address
First Line : 625 E FORDHAM RD
Second Line :
City : BRONX
State : NY
Zip : 10458-5049
Country : US
Telephone Number : 917-584-7654
Fax Number :
Provider Business Practice Location Address
First Line : 625 E FORDHAM RD
Second Line :
City : BRONX
State : NY
Zip : 10458-5049
Country : US
Telephone Number : 917-584-7654
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BERNARD GOYKHBERG
Credential :
Telephone Number : 917-584-7654
Provider Enumeration Date : 04/02/2026
Last Update Date : 04/02/2026

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Directions to “ALLIANCE MED SUPPLY LLC ” Practice Location

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