Provider Demographics
NPI:1881972040
Name:ALLY MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:ALLY MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ELDER
Authorized Official - Last Name:CIANFROCCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-785-8988
Mailing Address - Street 1:4951B E ADAMO DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-5924
Mailing Address - Country:US
Mailing Address - Phone:866-684-2507
Mailing Address - Fax:866-695-2183
Practice Address - Street 1:4951B E ADAMO DR
Practice Address - Street 2:SUITE 220
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-5924
Practice Address - Country:US
Practice Address - Phone:866-684-2507
Practice Address - Fax:866-695-2183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1881972040Medicaid
WY1881972040Medicaid
OH0094174Medicaid
ID1881972040Medicaid
MT1881972040Medicaid
NM96001038Medicaid
FL004438100Medicaid
MN1881972040Medicaid
NE10026392200Medicaid
MD4225571 00Medicaid
KY7100290040Medicaid
MT1881972040Medicaid