Provider Demographics
NPI:1801849013
Name:ALEXA MEDICAL SUPPLY CORPORATION
Entity Type:Organization
Organization Name:ALEXA MEDICAL SUPPLY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SILVERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-706-6679
Mailing Address - Street 1:610 W LAS OLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7141
Mailing Address - Country:US
Mailing Address - Phone:561-706-6679
Mailing Address - Fax:
Practice Address - Street 1:610 W LAS OLAS BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-7141
Practice Address - Country:US
Practice Address - Phone:561-706-6679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP01000065637332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies