Healthcare Provider Details

I. General information

NPI: 1114170610
Provider Name (Legal Business Name): ALLIED SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 STONECREEK BLVD UNIT E
CINCINNATI OH
45251-1469
US

IV. Provider business mailing address

3645 STONECREEK BLVD UNIT E
CINCINNATI OH
45251-1469
US

V. Phone/Fax

Practice location:
  • Phone: 513-687-0500
  • Fax: 513-598-1107
Mailing address:
  • Phone: 859-759-0668
  • Fax: 888-892-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: HUSAM HAMED
Title or Position: PRESIDENT
Credential: MD
Phone: 859-759-0668