Healthcare Provider Details

I. General information

NPI: 1922331867
Provider Name (Legal Business Name): ALLIANCE HEALTH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 MEDICAL CENTER DRIVE SUITE B
BATESVILLE MS
38606-8608
US

IV. Provider business mailing address

PO BOX 731804
DALLAS TX
75373-1084
US

V. Phone/Fax

Practice location:
  • Phone: 662-563-5611
  • Fax: 662-563-0155
Mailing address:
  • Phone: 662-563-2163
  • Fax: 662-563-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURIE HOLTSFORD
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-465-7466