Healthcare Provider Details

I. General information

NPI: 1043811243
Provider Name (Legal Business Name): ALLY HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 TARHEEL DR STE 106
RALEIGH NC
27609-7548
US

IV. Provider business mailing address

3811 TARHEEL DR STE 106
RALEIGH NC
27609-7548
US

V. Phone/Fax

Practice location:
  • Phone: 919-961-0000
  • Fax:
Mailing address:
  • Phone: 919-961-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD OKPARA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-961-0000