Provider Demographics
NPI:1346775046
Name:ALLEN FAMILY HOLDINGS, LLC
Entity Type:Organization
Organization Name:ALLEN FAMILY HOLDINGS, LLC
Other - Org Name:COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:940-484-0100
Mailing Address - Street 1:1612 SCRIPTURE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3809
Mailing Address - Country:US
Mailing Address - Phone:940-484-0100
Mailing Address - Fax:940-484-2600
Practice Address - Street 1:1612 SCRIPTURE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-484-0100
Practice Address - Fax:940-484-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313893336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149639Medicaid