Provider Demographics
NPI:1851027445
Name:ALEXANDER ROSS ENTERPRISES, LLC
Entity Type:Organization
Organization Name:ALEXANDER ROSS ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-338-6341
Mailing Address - Street 1:133 INDIAN LAKE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3883
Mailing Address - Country:US
Mailing Address - Phone:615-338-6341
Mailing Address - Fax:615-338-6342
Practice Address - Street 1:133 INDIAN LAKE RD STE 204
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3883
Practice Address - Country:US
Practice Address - Phone:615-338-6341
Practice Address - Fax:615-338-6342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty