Provider Demographics
NPI:1457032500
Name:ALLIANCE PRIMARY CARE LLC
Entity type:Organization
Organization Name:ALLIANCE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SSENGOBA-UBOGU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-588-1748
Mailing Address - Street 1:2101 HIGHLAND AVE S STE 350
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4009
Mailing Address - Country:US
Mailing Address - Phone:205-933-2125
Mailing Address - Fax:
Practice Address - Street 1:5330 STADIUM TRACE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4528
Practice Address - Country:US
Practice Address - Phone:205-588-1748
Practice Address - Fax:888-571-6217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty