Provider Demographics
NPI:1346740230
Name:ALLIANCE HEALTH CARE INC
Entity Type:Organization
Organization Name:ALLIANCE HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:SELENA
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-588-4779
Mailing Address - Street 1:3545 CRUSE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-3169
Mailing Address - Country:US
Mailing Address - Phone:770-456-5666
Mailing Address - Fax:770-456-5726
Practice Address - Street 1:3545 CRUSE RD STE 103
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-3169
Practice Address - Country:US
Practice Address - Phone:770-456-5666
Practice Address - Fax:770-456-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA663992085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA475566527OtherRADIOLOGY
GA475566527OtherRADIOLOGY