Healthcare Provider Details

I. General information

NPI: 1649865882
Provider Name (Legal Business Name): ALLIED HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 01/21/2024
Certification Date: 01/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11130 FAIRFAX BLVD
FAIRFAX VA
22030-5035
US

IV. Provider business mailing address

13116 MEMORY LN
FAIRFAX VA
22033-3506
US

V. Phone/Fax

Practice location:
  • Phone: 240-575-4698
  • Fax:
Mailing address:
  • Phone: 240-575-4698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS NDANGUM
Title or Position: OWNER/CEO
Credential:
Phone: 240-575-4698