Organization
ALLIANCE HEALTH PARTNERS LLC
Active
Other names
Tri-Lakes Pediatric RHC Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY HERRON (HMPN)
(662) 563-5611
Entity
Organization
Contact information
Practice address
435 HIGHWAY 6 E, BATESVILLE, MS 38606-3001
(662) 563-7873
(662) 563-8129
Mailing address
PO BOX 731804, DALLAS, TX 75373-1084
(662) 563-7873
(662) 563-8129
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09409733
—
MS
01
—
258516
MEDICARE
MS
Enumeration date
11/08/2006
Last updated
04/23/2013
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