Provider Demographics
NPI:1851427835
Name:ALLIANCE HOME CARE
Entity Type:Organization
Organization Name:ALLIANCE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:606-864-8777
Mailing Address - Street 1:PO BOX 1094
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-1094
Mailing Address - Country:US
Mailing Address - Phone:606-864-8777
Mailing Address - Fax:606-864-6856
Practice Address - Street 1:309 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1813
Practice Address - Country:US
Practice Address - Phone:606-864-8777
Practice Address - Fax:606-864-6856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90040262Medicaid
KY90040262Medicaid