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General NPI Number Information
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NPI Number | 1144503913
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Entity Type | Organization
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Legal Business Name | WILLIAM M. ALLEN, JR. LPN
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 1005 N COMMERCE ST APT. 4
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City | LEWISBURG
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State | OH
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Zip | 45338-9801
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Country | US
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Telephone | 937-678-1354
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 N COMMERCE ST APT. 4
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City | LEWISBURG
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State | OH
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Zip | 45338-9801
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Country | US
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Telephone | 937-678-1354
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MR. WILLIAM MELVIN ALLEN JR.
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Credential | LPN
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Telephone | 937-678-1354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | PN107462
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN107462
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License Number State | OH
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