Provider Demographics
NPI:1104199298
Name:DYNAMIC COMMERCE APPLICATIONS, INC.
Entity Type:Organization
Organization Name:DYNAMIC COMMERCE APPLICATIONS, INC.
Other - Org Name:ALTEGRA HEALTH, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-362-8799
Mailing Address - Street 1:3000 ATRIUM WAY STE 252
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3926
Mailing Address - Country:US
Mailing Address - Phone:610-543-2410
Mailing Address - Fax:
Practice Address - Street 1:3000 ATRIUM WAY STE 252
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3926
Practice Address - Country:US
Practice Address - Phone:610-543-2410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty