Provider Demographics
NPI:1497028351
Name:ALLIANCE HEALTHCARE CORP
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-390-9757
Mailing Address - Street 1:PO BOX 2050
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-2050
Mailing Address - Country:US
Mailing Address - Phone:813-931-0000
Mailing Address - Fax:813-909-8517
Practice Address - Street 1:1635 WILSON PIKE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8104
Practice Address - Country:US
Practice Address - Phone:813-931-0000
Practice Address - Fax:813-909-8517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTIN