Provider Demographics
NPI:1801929955
Name:ALVA HEALTH & MEDICAL SUPPLIES
Entity type:Organization
Organization Name:ALVA HEALTH & MEDICAL SUPPLIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-808-0866
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0128
Mailing Address - Country:US
Mailing Address - Phone:787-808-0866
Mailing Address - Fax:787-808-0866
Practice Address - Street 1:65 DE INFANTERIA
Practice Address - Street 2:#19
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-0128
Practice Address - Country:US
Practice Address - Phone:787-808-0866
Practice Address - Fax:787-808-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4683920001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50376OtherPMC PROVIDER #
PR50376OtherPMC PROVIDER #