Provider Demographics
NPI:1306837539
Name:ALFA - DELTA PROFESSIONAL AND HOME MEDICAL SUPPLY CO, INC
Entity Type:Organization
Organization Name:ALFA - DELTA PROFESSIONAL AND HOME MEDICAL SUPPLY CO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HELGA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GELBART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-444-3398
Mailing Address - Street 1:3526 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1028
Mailing Address - Country:US
Mailing Address - Phone:305-444-3398
Mailing Address - Fax:305-444-3396
Practice Address - Street 1:3526 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1028
Practice Address - Country:US
Practice Address - Phone:305-444-3398
Practice Address - Fax:305-444-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-05
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2222332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026142400Medicaid
FL026142400Medicaid