Provider Demographics
NPI: | 1538641055 |
---|---|
Name: | ALLIED HEALTHCARE LLC |
Entity Type: | Organization |
Organization Name: | ALLIED HEALTHCARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | OROS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 330-526-6663 |
Mailing Address - Street 1: | 9701 CLEVELAND AVE NW STE 152 |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTH CANTON |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44720-9834 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 330-526-6663 |
Mailing Address - Fax: | 330-913-7192 |
Practice Address - Street 1: | 9701 CLEVELAND AVE NW STE 152 |
Practice Address - Street 2: | |
Practice Address - City: | NORTH CANTON |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44720-9834 |
Practice Address - Country: | US |
Practice Address - Phone: | 330-526-6663 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-08-31 |
Last Update Date: | 2020-04-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101YA0400X, 101YM0800X, 163W00000X, 163WA0400X, 163WP0808X, 164W00000X, 2083A0300X, 208D00000X, 363L00000X, 363LF0000X | ||
OH | 35.094367 | 2084A0401X, 2084P0800X |
OH | 363LP0808X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2083A0300X | Allopathic & Osteopathic Physicians | Preventive Medicine | Addiction Medicine | Group - Multi-Specialty |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 163WA0400X | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
No | 2084A0401X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
36D2080652 | Other | CLIA |