MEDICARE: ALLIANCE FAMILY HEALTH CARE, PC

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	207Q00000X	Family Medicine Physician	0101049033	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	177116	OTHER		ANTHEM ID
2	23906	OTHER		OPTIMA (SENTARA)
3	0101049033	OTHER	VA	STATE ID

General Provider Information

NPI Number	:	1568485050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE FAMILY HEALTH CARE, PC

Provider Business Mailing Address
First Line	:	9323 MIDLOTHIAN TURNPIKE
Second Line	:	SUITE E
City	:	RICHMOND
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:	804-323-5575
Fax Number	:	804-323-0311

Provider Business Practice Location Address
First Line	:	9323 MIDLOTHIAN TPKE
Second Line	:	SUITE E
City	:	RICHMOND
State	:	VA
Zip	:	23235-4942
Country	:	US
Telephone Number	:	804-323-5575
Fax Number	:	804-323-0311

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MRS. ALFREDA BOOKER
Credential	:
Telephone Number	:	804-323-5575

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	03/07/2023

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Directions to “ALLIANCE FAMILY HEALTH CARE, PC ” Practice Location

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