Provider Demographics
NPI:1013213701
Name:ALPHA DURABLE MEDICAL EQUIPMENT SUPPLIES.
Entity Type:Organization
Organization Name:ALPHA DURABLE MEDICAL EQUIPMENT SUPPLIES.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:EREYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-721-1575
Mailing Address - Street 1:8147 DELMAR BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3735
Mailing Address - Country:US
Mailing Address - Phone:314-721-1575
Mailing Address - Fax:314-721-0545
Practice Address - Street 1:8147 DELMAR BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-3735
Practice Address - Country:US
Practice Address - Phone:314-721-1575
Practice Address - Fax:314-721-0545
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA HOME HEALTH MEDICAL SUPPLY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC0806203332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies