Healthcare Provider Details

I. General information

NPI: 1124415799
Provider Name (Legal Business Name): ALLIANCE XPRESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 S CRAIG AVE STE A
COVINGTON VA
24426-1954
US

IV. Provider business mailing address

1100 9TH ST STE E
VIENNA WV
26105-2176
US

V. Phone/Fax

Practice location:
  • Phone: 540-960-2231
  • Fax: 540-960-2245
Mailing address:
  • Phone: 304-916-1293
  • Fax: 304-916-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBIN Y DRUMMOND
Title or Position: VP REVENUE CYCLE MANAGEMENT
Credential:
Phone: 304-536-5030