MEDICARE: ALKA MEDICAL EQUIPMENT 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1821325713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALKA MEDICAL EQUIPMENT INC

Provider Business Mailing Address
First Line	:	2488 TAPO ST STE 3
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2492
Country	:	US
Telephone Number	:	805-522-1814
Fax Number	:	805-522-1838

Provider Business Practice Location Address
First Line	:	2488 TAPO ST STE 3
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2492
Country	:	US
Telephone Number	:	805-522-1814
Fax Number	:	805-522-1838

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OLEKSANDR IGNATENKO
Credential	:
Telephone Number	:	805-522-1814

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	11/19/2010

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