Organization Active NPI

Alpha 3 Medical Equipment, LLC

  • Durable Medical Equipment & Medical Supplies
  • Cape Girardeau, MO
National Provider Identifier
1184021487
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ALPHA 3 MEDICAL EQUIPMENT, LLC
Practice address
3065 William St
Space 207
Cape Girardeau, MO 63703-6393
Phone
(618) 438-0309
Fax
(618) 438-4406
NPI assigned
Dec 2, 2014
Last updated
Dec 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Franklin D Clark
Title
Owner
Phone
(618) 438-0309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

3065 William St
Space 207
Cape Girardeau, MO 63703-6393

Mailing address

603 Public SQ
Benton, IL 62812-2232
Phone (618) 438-0309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150828002191 MO DME Supplier - Medical Supply Company With Respiratory Therapist 1052627577 Practice locations: Cape Girardeau, MO

National Provider Directory

National Provider Directory

Locations

603 Public Sq
Benton, IL 62812

300 S Plaza Way
Cape Girardeau, MO 63703
Phone (573) 803-2996

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1184021487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 PUBLIC SQ",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628122232",
            "telephone_number": "618-438-0309",
            "fax_number": "618-438-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 WILLIAM ST",
            "address_2": "SPACE 207",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036393",
            "telephone_number": "618-438-0309",
            "fax_number": "618-438-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA 3 MEDICAL EQUIPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-438-0309",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.