Provider Demographics
NPI:1275158685
Name:ANGELICA MEDICAL SUPPLY CORP
Entity Type:Organization
Organization Name:ANGELICA MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIGOBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-536-2133
Mailing Address - Street 1:3534 W. FLAGLER ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1028
Mailing Address - Country:US
Mailing Address - Phone:786-536-2133
Mailing Address - Fax:786-536-2170
Practice Address - Street 1:3534 W FLAGLER ST.
Practice Address - Street 2:SUITE A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1028
Practice Address - Country:US
Practice Address - Phone:786-536-2133
Practice Address - Fax:786-536-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies