Brevard Health Alliance
LBN: The Brevard Health Alliance Inc
Brevard Health Alliance is an health care organization with primary practice located at 705 Blake Ave Bldg G, Cocoa FL 32922-7100. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
The Brevard Health Alliance Inc can be contacted via phone (321) 633-6391, or through Craig, Angela via phone (321) 952-9696.
Contact Information
Primary practice address
705 Blake Ave Bldg G
Cocoa FL 32922-7100
Phone: (321) 633-6391
Fax: (321) 633-6441
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1104121300 |
|---|---|
| LBN Legal business name | The Brevard Health Alliance Inc |
| DBA Doing business as | Brevard Health Alliance |
| Authorized official | Craig, Angela |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 19th, 2011 |
| Last updated | Nov 11th, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104121300 | NPPES |
| Florida | MEDICAID | 6886931-11 |
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