Provider Demographics
NPI:1962492165
Name:ALFA MANAGEMENT CORP
Entity type:Organization
Organization Name:ALFA MANAGEMENT CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AREIZAGA
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-502-1428
Mailing Address - Street 1:AVE MUNIZ SOUFFRONT
Mailing Address - Street 2:URB LOS MAESTROS 461
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923
Mailing Address - Country:US
Mailing Address - Phone:787-250-6056
Mailing Address - Fax:787-763-4791
Practice Address - Street 1:AVE MUNOZ SOUFFRONT AVENUE
Practice Address - Street 2:URB LOS MAESTROS 461
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-250-6056
Practice Address - Fax:787-763-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR17F25703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084653OtherPK