Msa Alliance, LLC

Nephrology Physician · Breese, IL

Organization Active NPI

NPI number 1467792960

Practice location

160 N Main St
Breese, IL 62230-1630
Phone
(618) 234-8246

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NPI record

NPI
1467792960
Entity type
Organization (Type 2)
Enumeration date
February 20, 2013
Last updated
February 28, 2013
Organization subpart
Yes
Parent organization
Msa Alliance, LLC

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nephrology Physician Primary 207RN0300X 036121947 IL

Mailing address

4500 Memorial Dr
Medical Affairs Credentialing Dept
Belleville, IL 62226-5360
Phone
(618) 257-4644
Fax
(618) 257-6946

Authorized official

Name
James B. Davis
Title
Executive Director
Phone
(618) 257-4644

About Msa Alliance, LLC

Msa Alliance, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Nephrology Physician (code 207RN0300X). The practice location is 160 N Main St, Breese, IL 62230-1630. The NPI number 1467792960 was assigned on February 20, 2013 and the record was last updated on February 28, 2013.

Msa Alliance, LLC lists a license in the registry: #036121947 (IL) for Nephrology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is James B. Davis, Executive Director.

Frequently asked questions

What is the NPI number of Msa Alliance, LLC?

The NPI number is 1467792960.

What is the phone number of Msa Alliance, LLC?

The phone number listed for the practice location is (618) 234-8246.

Where is Msa Alliance, LLC located?

160 N Main St, Breese, IL 62230-1630.

What is the taxonomy code for Msa Alliance, LLC?

The primary taxonomy code is 207RN0300X – Nephrology Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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