# ALLY MEDICAL SUPPLY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diabetic Shoes Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508261926
- **Authorized official:** LIBAN ALI HASSAN (PRESIDENT)
- **Authorized official phone:** (612) 208-0282

## Contact information

- **Practice address:** 6238 LYNDALE AVE SOUTH, SUITE \# 2, RICHFIELD, MN 55423
- **Practice address phone:** (612) 208-0282
- **Practice address fax:** (612) 345-5582
- **Mailing address:** 6238 LYNDALE AVE SOUTH, SUITE \# 2, RICHFIELD, MN 55423
- **Mailing address phone:** (612) 208-0282
- **Mailing address fax:** (612) 345-5582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 10/28/2014
- **Last updated:** 10/05/2018