Provider Demographics
NPI:1356328595
Name:ALLIED HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ALLIED HEALTHCARE SERVICES
Other - Org Name:WILLIAM WARREN CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-826-3836
Mailing Address - Street 1:100 ABINGTON EXECUTIVE PARK
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2258
Mailing Address - Country:US
Mailing Address - Phone:570-348-2911
Mailing Address - Fax:
Practice Address - Street 1:475 MORGAN HWY
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2605
Practice Address - Country:US
Practice Address - Phone:570-341-4317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000002910030Medicaid