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NPI Code Detail

MEDICARE: ALLIANCE PRIMARY CARE

MEDICARE: ALLIANCE PRIMARY CARE
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1699945113
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE PRIMARY CARE
Provider Business Mailing Address
First Line : 3200 BURNET AVE
Second Line : 1 RIDGEWAY
City : CINCINNATI
State : OH
Zip : 45229-3019
Country : US
Telephone Number : 513-585-9009
Fax Number : 513-585-6146
Provider Business Practice Location Address
First Line : 6045 BRIDGETOWN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-3049
Country : US
Telephone Number : 513-921-4227
Fax Number : 513-347-4620
Authorized Official
Title or Position : DIRECTOR OF PATIENT ACCOUNTING
Name : JAMES LARSON
Credential :
Telephone Number : 513-585-9336
Provider Enumeration Date : 03/12/2008
Last Update Date : 03/12/2008

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Directions to “ALLIANCE PRIMARY CARE ” Practice Location

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