Healthcare Provider Details

I. General information

NPI: 1841241049
Provider Name (Legal Business Name): ALLENS PHARMASERV INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 GYPSY LN
YOUNGSTOWN OH
44504-1315
US

IV. Provider business mailing address

PO BOX 2208
YOUNGSTOWN OH
44504-0208
US

V. Phone/Fax

Practice location:
  • Phone: 330-744-0707
  • Fax: 330-744-1244
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number020633750
License Number StateOH

VIII. Authorized Official

Name: ALAN MIRKIN
Title or Position: PRESIDENT
Credential:
Phone: 330-744-0707