| Alliance Health Centers, Inc. | |
|
2700 Lafayette St Fort Wayne IN 46806-1100 | |
| (812) 230-5150 | |
| Not Available |
| Full Name | Alliance Health Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2700 Lafayette St, Fort Wayne, Indiana |
| Authorized Official Name and Position | Brooke Lockhart (CEO) |
| Authorized Official Contact | 2602660780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Health Centers, Inc. 2700 Lafayette St Fort Wayne IN 46806-1100 Ph: (260) 266-0780 | Alliance Health Centers, Inc. 2700 Lafayette St Fort Wayne IN 46806-1100 Ph: (812) 230-5150 |
| NPI Number | 1316556848 |
|---|---|
| Provider Enumeration Date | 07/30/2020 |
| Last Update Date | 12/08/2021 |
| Medicare PECOS PAC ID | 8022437318 |
|---|---|
| Medicare Enrollment ID | O20201006002848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316556848 | NPI | - | NPPES |
| 300043694 | Medicaid | IN |
| Provider Name | John E Marx |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720491731 PECOS PAC ID: 2365669710 Enrollment ID: I20160728001914 |
| Provider Name | Sherri Sue Albertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609437425 PECOS PAC ID: 9234464892 Enrollment ID: I20190718002060 |
| Provider Name | Eric Shoemaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851749147 PECOS PAC ID: 7719278506 Enrollment ID: I20190722002937 |
| Provider Name | Kirby Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528553815 PECOS PAC ID: 7012343684 Enrollment ID: I20200130002715 |
| Provider Name | Aiwen Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225561798 PECOS PAC ID: 1557787959 Enrollment ID: I20200817000921 |
| Provider Name | Amber M. Hiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063977833 PECOS PAC ID: 2860801990 Enrollment ID: I20210503000311 |
| Provider Name | Lara Maria Lahr |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1942843701 PECOS PAC ID: 1456696616 Enrollment ID: I20230515000586 |
| Provider Name | Amy Rae Reeser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962188656 PECOS PAC ID: 8426418971 Enrollment ID: I20230717001017 |
| Provider Name | Mark Alan Boxell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326817560 PECOS PAC ID: 1759727316 Enrollment ID: I20240306002017 |
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