Provider Demographics
NPI:1457733859
Name:ALCANTARA ENTERPRISES INCORPORATED
Entity Type:Organization
Organization Name:ALCANTARA ENTERPRISES INCORPORATED
Other - Org Name:KASAGANAAN ENTERPRISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODIL
Authorized Official - Middle Name:DEANG
Authorized Official - Last Name:ALCANTARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-361-2645
Mailing Address - Street 1:239 NE 178TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-3538
Mailing Address - Country:US
Mailing Address - Phone:206-361-2645
Mailing Address - Fax:206-420-1638
Practice Address - Street 1:239 NE 178TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3538
Practice Address - Country:US
Practice Address - Phone:206-361-2645
Practice Address - Fax:206-420-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602927366332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies