Healthcare Provider Details

I. General information

NPI: 1033186333
Provider Name (Legal Business Name): ALLIANCE HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HIGHWAY 6 E
BATESVILLE MS
38606-3001
US

IV. Provider business mailing address

PO BOX 731804
DALLAS TX
75373-1804
US

V. Phone/Fax

Practice location:
  • Phone: 662-563-7873
  • Fax: 662-563-8129
Mailing address:
  • Phone: 662-563-7873
  • Fax: 662-563-8129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNY HERRON
Title or Position: HMPN
Credential:
Phone: 662-563-5611