Provider Demographics
NPI:1306176672
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:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:PITINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-253-6881
Mailing Address - Street 1:3006 EASTPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4185
Mailing Address - Country:US
Mailing Address - Phone:502-253-6881
Mailing Address - Fax:502-253-6882
Practice Address - Street 1:600 BOULEVARD SOUTH
Practice Address - Street 2:SUITE 104
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2175
Practice Address - Country:US
Practice Address - Phone:256-705-3545
Practice Address - Fax:256-705-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL940332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009914272Medicaid
AL009914272Medicaid