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General NPI Number Information
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NPI Number | 1174868350
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Entity Type | Organization
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Legal Business Name | ALLIANCE DME
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Dates
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Enumeration Date | 11/29/2012
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 67 E SAINT JOE ST
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City | HILLSDALE
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State | MI
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Zip | 49242
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Country | US
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Telephone | 517-849-7259
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 326
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City | HILLSDALE
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State | MI
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Zip | 49242
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Country | US
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Telephone | 517-849-7259
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JASON WALTERS
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Credential |
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Telephone | 517-849-7259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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