Organization
ALLIANCE HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LONGMORE-GRUND (EXEC VP & CFO)
(800) 544-3215
Entity
Organization
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843
(208) 882-4511
Mailing address
100 BAYVIEW CIR, SUITE 400, NEWPORT BEACH, CA 92660-2983
(800) 544-3215
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806692601
—
ID
01
—
P00398206
RAILROAD MEDICARE
ID
Enumeration date
05/03/2007
Last updated
09/30/2016
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