Provider Demographics
NPI:1003022575
Name:AVALON MEDICAL SERVICES
Entity Type:Organization
Organization Name:AVALON MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUNKLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-327-8932
Mailing Address - Street 1:1058 BERNARD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1610
Mailing Address - Country:US
Mailing Address - Phone:614-327-8932
Mailing Address - Fax:
Practice Address - Street 1:1058 BERNARD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-1610
Practice Address - Country:US
Practice Address - Phone:614-327-8932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH295326251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care