1962724526 NPI number — HEALTH EQUITY ALLIANCE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962724526 NPI number — HEALTH EQUITY ALLIANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH EQUITY ALLIANCE
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:
Provider Other Organization Name Type Code:
6
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:
1962724526
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
304 HANCOCK ST
Provider Second Line Business Mailing Address:
SUITE 3B
Provider Business Mailing Address City Name:
BANGOR
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04401-6573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-888-2129
Provider Business Mailing Address Fax Number:
207-888-2129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 HANCOCK ST
Provider Second Line Business Practice Location Address:
SUITE 3B
Provider Business Practice Location Address City Name:
BANGOR
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04401-6573
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-990-3626
Provider Business Practice Location Address Fax Number:
207-664-0574
Provider Enumeration Date:
02/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
D ALESSIO
Authorized Official First Name:
JOSHUA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
207-990-3626

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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