Provider Demographics
NPI:1982874087
Name:ALLEGIANCE HOME MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:ALLEGIANCE HOME MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JEANE
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-323-5942
Mailing Address - Street 1:61958 CARNATION RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-9588
Mailing Address - Country:US
Mailing Address - Phone:970-323-5942
Mailing Address - Fax:970-323-5988
Practice Address - Street 1:61958 CARNATION RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425-9588
Practice Address - Country:US
Practice Address - Phone:970-323-5942
Practice Address - Fax:970-323-5988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4509240001Medicare NSC