1386807576 NPI number — ALLIANCE ONCOLOGY LLC

Table of content: (NPI 1386807576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386807576 NPI number — ALLIANCE ONCOLOGY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIANCE ONCOLOGY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMONWEALTH NEWBURYPORT CANCER CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386807576
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 BAYVIEW CIR
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660-2983
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-242-5384
Provider Business Mailing Address Fax Number:
480-212-8589

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 WALLACE BASHAW WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBURYPORT
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-229-7226
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WEEKS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
256-383-3325

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0203X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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