1154328086 NPI number — ALDO SURGICAL & HOSPITAL SUPPLY, INC.

Table of content: (NPI 1154328086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154328086 NPI number — ALDO SURGICAL & HOSPITAL SUPPLY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALDO SURGICAL & HOSPITAL SUPPLY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154328086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8074 NW 103RD ST
Provider Second Line Business Mailing Address:
SUITE 21
Provider Business Mailing Address City Name:
HIALEAH GARDENS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-2256
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-557-2835
Provider Business Mailing Address Fax Number:
305-821-3645

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8074 NW 103RD ST
Provider Second Line Business Practice Location Address:
SUITE 21
Provider Business Practice Location Address City Name:
HIALEAH GARDENS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33016-2256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-557-2835
Provider Business Practice Location Address Fax Number:
305-821-3645
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
AMAT
Authorized Official First Name:
ADELINA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-557-2835

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  1249 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335E00000X , with the licence number: ORTHOTICS ONLY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 099764198 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 099764196 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201494700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 099764103 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201494700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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