Provider Demographics
NPI:1093295792
Name:ALLIANCE URGENT CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ALLIANCE URGENT CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMPERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-526-4635
Mailing Address - Street 1:74 PLEASANT ST STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5881
Mailing Address - Country:US
Mailing Address - Phone:603-526-4635
Mailing Address - Fax:603-526-8283
Practice Address - Street 1:558 MAST RD
Practice Address - Street 2:
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-5256
Practice Address - Country:US
Practice Address - Phone:603-232-1790
Practice Address - Fax:032-322-5306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3115122Medicaid
NH3115121Medicaid