MEDICARE: AMHERST ALLIANCE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2388R	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000335830	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1366445660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMHERST ALLIANCE, LLC

Provider Business Mailing Address
First Line	:	1610 1ST ST NE
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-4044
Country	:	US
Telephone Number	:	216-661-6800
Fax Number	:	216-739-3789

Provider Business Practice Location Address
First Line	:	1610 1ST ST NE
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-4044
Country	:	US
Telephone Number	:	216-661-6800
Fax Number	:	216-739-3789

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MR. DANIEL SHILLER
Credential	:
Telephone Number	:	440-684-9220

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	05/03/2021

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Directions to “AMHERST ALLIANCE, LLC ” Practice Location

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