Provider Demographics
NPI:1255135471
Name:ALLIANCE MEDICAL CENTER LLC
Entity type:Organization
Organization Name:ALLIANCE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:801-330-0454
Mailing Address - Street 1:683 W 5300 S
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5671
Mailing Address - Country:US
Mailing Address - Phone:801-330-0454
Mailing Address - Fax:
Practice Address - Street 1:683 W 5300 S
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-5671
Practice Address - Country:US
Practice Address - Phone:801-330-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty