Healthcare Provider Details

I. General information

NPI: 1699929562
Provider Name (Legal Business Name): ALLIANCE COMMUNITY MEDICAL FOUNDATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E STATE ST
ALLIANCE OH
44601-4936
US

IV. Provider business mailing address

200 E STATE ST
ALLIANCE OH
44601-4936
US

V. Phone/Fax

Practice location:
  • Phone: 330-596-6570
  • Fax: 330-829-8689
Mailing address:
  • Phone: 330-829-9389
  • Fax: 330-829-9372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: LISA GEIGER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 330-596-7528