Provider Demographics
NPI:1578791562
Name:ALLIANCE MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL SOLUTIONS LLC
Other - Org Name:ALLIANCE BRACING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-253-6881
Mailing Address - Street 1:6009 BROWNSBORO PARK BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1291
Mailing Address - Country:US
Mailing Address - Phone:502-253-6881
Mailing Address - Fax:502-253-6882
Practice Address - Street 1:9736 DAYTON PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4727
Practice Address - Country:US
Practice Address - Phone:423-332-5155
Practice Address - Fax:423-332-5195
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLIANCE MEDICAL HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-29
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000791332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1455152Medicaid
TN1455152Medicaid