Healthcare Provider Details

I. General information

NPI: 1336321124
Provider Name (Legal Business Name): ALLIED HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 09/01/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT PA
18411-2260
US

IV. Provider business mailing address

100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT PA
18411-2260
US

V. Phone/Fax

Practice location:
  • Phone: 570-340-6450
  • Fax: 570-702-8747
Mailing address:
  • Phone: 570-340-6450
  • Fax: 570-702-8747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPP481775
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2082478
Identifier TypeOTHER
Identifier State
Identifier IssuerPK
# 2
Identifier1000002910069
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: KEVIN BOWMAN
Title or Position: ASST VP PHARMACY
Credential: PHARM D,MBA,BCGP
Phone: 570-340-6450