MEDICARE: RX ALLIANCE, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	207QA0401X	Addiction Medicine (Family Medicine) Physician
4	363AM0700X	Medical Physician Assistant
5	207QS0010X	Sports Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1598132854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX ALLIANCE, LLC

Provider Business Mailing Address
First Line	:	5 E LONG ST
Second Line	:	SUITE 501
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2915
Country	:	US
Telephone Number	:	614-648-0515
Fax Number	:	855-853-8870

Provider Business Practice Location Address
First Line	:	5 E LONG ST
Second Line	:	SUITE 501
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2915
Country	:	US
Telephone Number	:	614-648-0515
Fax Number	:	855-853-8870

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES E STURMI
Credential	:	MD
Telephone Number	:	614-648-0515

Provider Enumeration Date	:	08/21/2015
Last Update Date	:	08/31/2015

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