Provider Demographics
NPI:1659718401
Name:ALLIANCE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAMEO
Authorized Official - Middle Name:KAE
Authorized Official - Last Name:ZEHNDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-642-1825
Mailing Address - Street 1:224 BUDDY HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-1435
Mailing Address - Country:US
Mailing Address - Phone:432-580-0171
Mailing Address - Fax:432-580-7686
Practice Address - Street 1:224 BUDDY HOLLY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401-1435
Practice Address - Country:US
Practice Address - Phone:432-580-0171
Practice Address - Fax:432-580-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0046215332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies