Provider Demographics
NPI:1376547398
Name:ALLENS PHARMACY INC
Entity Type:Organization
Organization Name:ALLENS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:570-342-8219
Mailing Address - Street 1:402 PRESCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-2399
Mailing Address - Country:US
Mailing Address - Phone:570-342-8219
Mailing Address - Fax:570-342-8219
Practice Address - Street 1:402 PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2399
Practice Address - Country:US
Practice Address - Phone:570-342-8219
Practice Address - Fax:570-342-8219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410051L333600000X
PARP024515L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0123800001Medicare NSC