Healthcare Provider Details

I. General information

NPI: 1407208085
Provider Name (Legal Business Name): MERAKEY ALLOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 N FAIR AVE
HAMILTON OH
45011-4222
US

IV. Provider business mailing address

620 GERMANTOWN PIKE
LAFAYETTE HILL PA
19444-1810
US

V. Phone/Fax

Practice location:
  • Phone: 215-836-3131
  • Fax: 215-273-5975
Mailing address:
  • Phone: 215-836-3131
  • Fax: 215-273-5975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NORMAN E TILSON JR.
Title or Position: CORP SR. DIRECTOR OF BUSINESS OPS
Credential:
Phone: 215-836-3131