Provider Demographics
NPI:1063573715
Name:ALLIANCE MEDICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:ALLIANCE MEDICAL SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PITINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-253-6881
Mailing Address - Street 1:6009 BROWNSBORO PARK BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1291
Mailing Address - Country:US
Mailing Address - Phone:502-253-6881
Mailing Address - Fax:502-253-6882
Practice Address - Street 1:6009 BROWNSBORO PARK BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-1291
Practice Address - Country:US
Practice Address - Phone:502-253-6881
Practice Address - Fax:502-253-6882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLIANCE MEDICAL HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-13
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100003400Medicaid
KY7100003400Medicaid