# ALLIANCE MEDICAL SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386990364
- **Authorized official:** KENNETH BRODHAGEN (PRESIDENT)
- **Authorized official phone:** (714) 348-6759

## Contact information

- **Practice address:** 12601 SAN FERNANDO RD, SUITE F, SYLMAR, CA 91342-7733
- **Practice address phone:** (818) 833-7000
- **Practice address fax:** (818) 514-2447
- **Mailing address:** 12601 SAN FERNANDO RD, SUITE F, SYLMAR, CA 91342-7733
- **Mailing address phone:** (818) 833-7000
- **Mailing address fax:** (818) 514-2447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | CA | Yes |

## Other

- **Enumeration date:** 07/27/2012
- **Last updated:** 09/17/2015