Provider Demographics
NPI:1659540649
Name:ALPHA DIABETIC SUPPLIES, INC.
Entity Type:Organization
Organization Name:ALPHA DIABETIC SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KULDEEP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:HAJELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-932-5742
Mailing Address - Street 1:1350 S POWERLINE RD
Mailing Address - Street 2:#108
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4330
Mailing Address - Country:US
Mailing Address - Phone:877-932-5742
Mailing Address - Fax:877-512-5742
Practice Address - Street 1:1350 S POWERLINE RD
Practice Address - Street 2:#108
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4330
Practice Address - Country:US
Practice Address - Phone:877-932-5742
Practice Address - Fax:877-512-5742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6378490001Medicare NSC