Provider Demographics
NPI:1093769242
Name:ALPHA AIR DME, INC.
Entity Type:Organization
Organization Name:ALPHA AIR DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:CHRIS
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-461-8046
Mailing Address - Street 1:26341 JEFFERSON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6974
Mailing Address - Country:US
Mailing Address - Phone:951-461-8046
Mailing Address - Fax:951-461-8385
Practice Address - Street 1:26341 JEFFERSON AVE STE E
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6974
Practice Address - Country:US
Practice Address - Phone:951-461-8046
Practice Address - Fax:951-461-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74462332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02898FMedicaid
CA4129770001Medicare NSC