Healthcare Provider Details

I. General information

NPI: 1174359020
Provider Name (Legal Business Name): AHCS ALLEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 C ST STE 100
SAN DIEGO CA
92101-4809
US

IV. Provider business mailing address

17011 BEACH BLVD STE 200
HUNTINGTON BEACH CA
92647-7421
US

V. Phone/Fax

Practice location:
  • Phone: 619-232-8101
  • Fax:
Mailing address:
  • Phone: 714-706-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOMAS P LAM
Title or Position: VP COMPLIANCE AND RISK MANGEMENT
Credential:
Phone: 714-706-9030