MEDICARE: ALLIANCE MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1174472773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE MEDICAL GROUP

Provider Business Mailing Address
First Line	:	6670 S TENAYA WAY STE 190
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1964
Country	:	US
Telephone Number	:	864-590-1795
Fax Number	:

Provider Business Practice Location Address
First Line	:	6670 S TENAYA WAY STE 190
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1964
Country	:	US
Telephone Number	:	864-590-1795
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JON HEARD
Credential	:
Telephone Number	:	864-590-1795

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ALLIANCE MEDICAL GROUP ” Practice Location

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