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General NPI Number Information
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NPI Number | 1093002057
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Entity Type | Organization
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Legal Business Name | ALLIANCE MEDICATION SERVICES, LLC.
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/11/2015
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Provider Practice Location Address
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Address Line | 88 MAHANOY AVE
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City | TAMAQUA
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State | PA
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Zip | 18252-4002
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Country | US
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Telephone | 866-668-8590
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Fax | 570-668-1490
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Provider Business Mailing Address
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Address Line | PO BOX 222
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City | BARNESVILLE
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State | PA
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Zip | 18214-0222
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Country | US
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Telephone | 570-668-8820
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Fax | 570-668-8825
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ANDRE HINCHMAN
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Credential |
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Telephone | 570-668-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PP482133
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License Number State | PA
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