MEDICARE: ALLIANCE DME, LLC

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	:	1710257894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE DME, LLC

Provider Business Mailing Address
First Line	:	9535 FOREST LN
Second Line	:	SUITE # 100A
City	:	DALLAS
State	:	TX
Zip	:	75243-5900
Country	:	US
Telephone Number	:	972-733-0392
Fax Number	:	972-733-0997

Provider Business Practice Location Address
First Line	:	9535 FOREST LN
Second Line	:	SUITE # 100A
City	:	DALLAS
State	:	TX
Zip	:	75243-5900
Country	:	US
Telephone Number	:	972-733-0392
Fax Number	:	972-733-0997

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. JAMES D BUCK
Credential	:	OWNER
Telephone Number	:	972-733-0392

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	04/10/2012

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