Provider Demographics
NPI:1124415799
Name:ALLIANCE XPRESS CARE LLC
Entity Type:Organization
Organization Name:ALLIANCE XPRESS CARE LLC
Other - Org Name:ALLIANCE XPRESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-536-5030
Mailing Address - Street 1:1100 9TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-2176
Mailing Address - Country:US
Mailing Address - Phone:304-916-1293
Mailing Address - Fax:304-916-1705
Practice Address - Street 1:919 S CRAIG AVE STE A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-1954
Practice Address - Country:US
Practice Address - Phone:540-960-2231
Practice Address - Fax:540-960-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1124415799Medicaid
VAE984Medicare PIN