Provider Demographics
NPI:1073178174
Name:ALLEVIATE SUPPLY
Entity Type:Organization
Organization Name:ALLEVIATE SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUITRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-301-1054
Mailing Address - Street 1:1894 E WILLIAM ST STE 4-201
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-3224
Mailing Address - Country:US
Mailing Address - Phone:775-301-1054
Mailing Address - Fax:
Practice Address - Street 1:1894 E WILLIAM ST STE 4-201
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3224
Practice Address - Country:US
Practice Address - Phone:775-301-1054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies