Provider Demographics
NPI:1184021487
Name:ALPHA 3 MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:ALPHA 3 MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-438-0309
Mailing Address - Street 1:603 PUBLIC SQ
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:IL
Mailing Address - Zip Code:62812-2232
Mailing Address - Country:US
Mailing Address - Phone:618-438-0309
Mailing Address - Fax:618-438-4406
Practice Address - Street 1:3065 WILLIAM ST
Practice Address - Street 2:SPACE 207
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6393
Practice Address - Country:US
Practice Address - Phone:618-438-0309
Practice Address - Fax:618-438-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies