MEDICARE: ALI AUTO 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1881440196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALI AUTO LLC

Provider Business Mailing Address
First Line	:	3216 BETHEL AVE
Second Line	:
City	:	PENNSAUKEN
State	:	NJ
Zip	:	08109-2710
Country	:	US
Telephone Number	:	856-518-1503
Fax Number	:

Provider Business Practice Location Address
First Line	:	3216 BETHEL AVE
Second Line	:
City	:	PENNSAUKEN
State	:	NJ
Zip	:	08109-2710
Country	:	US
Telephone Number	:	856-518-1503
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MIKAL ALI
Credential	:
Telephone Number	:	856-518-1503

Provider Enumeration Date	:	04/26/2024
Last Update Date	:	04/26/2024

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Directions to “ALI AUTO LLC ” Practice Location

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