=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710352224
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLIANCE HEALTH SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2015
-----------------------------------------------------
Last Update Date | 12/09/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8 WOODSTONE PLZ SUITE 5
-----------------------------------------------------
City | HATTIESBURG
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39402-8390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-336-7012
-----------------------------------------------------
Fax | 601-336-5390
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8 WOODSTONE PLZ SUITE 5
-----------------------------------------------------
City | HATTIESBURG
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39402-8390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-336-7012
-----------------------------------------------------
Fax | 601-336-5390
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | MRS. JULIE BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 601-336-7012
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------