Provider Demographics
NPI:1407320401
Name:ALLIANCE MEDICAL SUPPLY LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL SUPPLY LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUFANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-423-3946
Mailing Address - Street 1:207 COMMERCIAL CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1070
Mailing Address - Country:US
Mailing Address - Phone:732-719-7168
Mailing Address - Fax:732-554-8198
Practice Address - Street 1:207 COMMERCIAL CT
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1070
Practice Address - Country:US
Practice Address - Phone:732-719-7168
Practice Address - Fax:732-554-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies