Provider Demographics
NPI:1700409547
Name:ALLIANCE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:N
Authorized Official - Last Name:COVIL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:757-306-2700
Mailing Address - Street 1:1308 COPPER KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3393
Mailing Address - Country:US
Mailing Address - Phone:757-285-9591
Mailing Address - Fax:
Practice Address - Street 1:3750 SENTARA WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4200
Practice Address - Country:US
Practice Address - Phone:757-306-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty