Provider Demographics
NPI:1881044253
Name:ALLIANCE MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-717-1066
Mailing Address - Street 1:7900 GLADES RD STE 260
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4100
Mailing Address - Country:US
Mailing Address - Phone:888-482-0903
Mailing Address - Fax:
Practice Address - Street 1:7900 GLADES RD STE 260
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4100
Practice Address - Country:US
Practice Address - Phone:888-482-0903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies