Provider Demographics
NPI:1518943448
Name:ALLIED HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ALLIED HEALTHCARE SERVICES
Other - Org Name:IN HOME SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER-BROZENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-348-1367
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:570-341-4676
Practice Address - Street 1:100 ABINGTON EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2258
Practice Address - Country:US
Practice Address - Phone:570-348-2911
Practice Address - Fax:570-341-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PW1000002910025Medicaid
PA1000002910050Medicaid
PA1000002910059Medicaid