MEDICARE: ALLIANCE HEALTH PHARMACY 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1932922366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE HEALTH PHARMACY LLC

Provider Business Mailing Address
First Line	:	1795 N BUTTERFIELD RD STE 108
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-1212
Country	:	US
Telephone Number	:	847-909-2088
Fax Number	:

Provider Business Practice Location Address
First Line	:	1795 N BUTTERFIELD RD STE 108
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-1212
Country	:	US
Telephone Number	:	847-909-2088
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	DALIA THOMAS
Credential	:
Telephone Number	:	847-909-2088

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/13/2024

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