Provider Demographics
NPI:1679076335
Name:ALPHA SURGICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:ALPHA SURGICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:601-622-0018
Mailing Address - Street 1:PO BOX 1666
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39130-1666
Mailing Address - Country:US
Mailing Address - Phone:601-672-3512
Mailing Address - Fax:
Practice Address - Street 1:7048 OLD CANTON RD STE 220
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1021
Practice Address - Country:US
Practice Address - Phone:601-672-3512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16964332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies