Healthcare Provider Details

I. General information

NPI: 1932592615
Provider Name (Legal Business Name): ALLCARE & ALLIED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 ABBEY TER
DREXEL HILL PA
19026-2041
US

IV. Provider business mailing address

117 ABBEY TER
DREXEL HILL PA
19026-2041
US

V. Phone/Fax

Practice location:
  • Phone: 610-622-1919
  • Fax:
Mailing address:
  • Phone: 610-622-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number26093601
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier26093601
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. OLAYINKA BALOGUN
Title or Position: GENERAL MANAGER
Credential:
Phone: 484-995-4560