MEDICARE: ALPHA SUPPLIES 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	:	1790617413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA SUPPLIES LLC

Provider Business Mailing Address
First Line	:	2800 E ENTERPRISE AVE STE 333
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54913-7889
Country	:	US
Telephone Number	:	320-577-7824
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 E ENTERPRISE AVE STE 333
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54913-7889
Country	:	US
Telephone Number	:	320-577-7824
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SAIKUMAR PULIMAMIDI
Credential	:	MR
Telephone Number	:	320-577-7824

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ALPHA SUPPLIES LLC ” Practice Location

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