Provider Demographics
NPI:1861815797
Name:ALTO MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:ALTO MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:FURELOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-762-5088
Mailing Address - Street 1:1421 E BROAD ST
Mailing Address - Street 2:SUITE 241
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-1968
Mailing Address - Country:US
Mailing Address - Phone:919-762-5088
Mailing Address - Fax:
Practice Address - Street 1:1421 E BROAD ST
Practice Address - Street 2:SUITE 241
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1968
Practice Address - Country:US
Practice Address - Phone:919-762-5088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2015-03-17
Deactivation Date:2014-12-10
Deactivation Code:
Reactivation Date:2015-03-17
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies