Alliance Healthcare Services Inc
Organization Active NPI Mobile Radiology Clinic/Center · Prescott Valley, AZ
NPI 1154540979 · NPPES record last updated Sep 20, 2016
Key facts
- NPI
- 1154540979
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mobile Radiology Clinic/Center 261QR0208X
- License
- 15-078 (AZ)
- Legal business name
- ALLIANCE HEALTHCARE SERVICES INC
- Practice address
- 3262 N Windsong Dr
Prescott Valley, AZ 86314-2255 - Phone
- (928) 759-5800
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Rhonda Longmore-Grund
- Title
- Exec VP & Cfo
- Phone
- (800) 544-3215
Other NPIs on the same Medicare enrollment 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040616000791 | AZ | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 4284546870 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Glendale, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mobile Radiology Clinic/Center | 261QR0208X | 15-078 | AZ | Yes |
Addresses
Primary practice location
3262 N Windsong Dr
Prescott Valley, AZ 86314-2255
Mailing address
100 Bayview Cir
Suite 400
Newport Beach, CA 92660-2983
Phone (800) 544-3215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53890206 | Medicaid | AZ | |
| 204657 | Medicaid | AZ | |
| 470001908 | Other | AZ | RAILROAD MEDICARE |
Other providers in Prescott Valley, AZ
- Theresa Alef
- Heidi S Alessi
- John R Alessi
- Karen Alexander
- Francis Allen
- Holly Ann Allred
- Jennifer Marie Almendarez
- Michael Eugene Alquist
- Ambient Healthcare, PLLC
- Meagan Sue Anderson
All providers in Prescott Valley, AZ · Mobile Radiology Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.