MEDICARE: ALLYN HEALTHCARE PROFESSIONALS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC3530	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518099522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLYN HEALTHCARE PROFESSIONALS, LLC

Provider Business Mailing Address
First Line	:	5530 ANGEL OAKS DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-9112
Country	:	US
Telephone Number	:	336-377-9190
Fax Number	:	336-377-2544

Provider Business Practice Location Address
First Line	:	5530 ANGEL OAKS DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-9112
Country	:	US
Telephone Number	:	336-377-9190
Fax Number	:	336-377-2544

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. BOBBIETTE ALLEN DAVID
Credential	:	RN
Telephone Number	:	336-377-9190

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	09/04/2007

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