Provider Demographics
NPI:1669492138
Name:MALKA GREENE ALLEY INC.
Entity Type:Organization
Organization Name:MALKA GREENE ALLEY INC.
Other - Org Name:ADJUSTABLE BED MART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-321-0579
Mailing Address - Street 1:67555 E PALM CANYON DR
Mailing Address - Street 2:SUITE F118
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-5467
Mailing Address - Country:US
Mailing Address - Phone:760-321-0579
Mailing Address - Fax:760-321-5790
Practice Address - Street 1:67555 E PALM CANYON DR
Practice Address - Street 2:SUITE F118
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-5467
Practice Address - Country:US
Practice Address - Phone:760-321-0579
Practice Address - Fax:760-321-5790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103798332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0490090001OtherNSC