# ALLIANCE MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Primary Health Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871969246
- **Authorized official:** LINDA BARNES (CREDENTIALING MGR)
- **Authorized official phone:** (208) 985-1423

## Contact information

- **Practice address:** 4971 W. OVERLAND ROAD, BOISE, ID 83705
- **Practice address phone:** (208) 472-5050
- **Practice address fax:** (208) 472-5051
- **Mailing address:** PO BOX 191050, BOISE, ID 83719-1050
- **Mailing address phone:** (208) 955-6500
- **Mailing address fax:** (208) 955-6503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2015
- **Last updated:** 02/17/2025