Provider Demographics
NPI:1558019075
Name:ALPHATECH PUERTO RICO LLC
Entity Type:Organization
Organization Name:ALPHATECH PUERTO RICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CENTENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-810-5024
Mailing Address - Street 1:1353 AVE LUIS VIGOREAUX
Mailing Address - Street 2:PMB 473
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PLAZA 65 SHOPPING CENTER #27
Practice Address - Street 2:AVE 65 INFANTERIA PR-3
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-810-5024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment