Provider Demographics
NPI:1710589460
Name:PROCARE LTC OHIO ACQUISITION CO I, LLC
Entity Type:Organization
Organization Name:PROCARE LTC OHIO ACQUISITION CO I, LLC
Other - Org Name:ALLEN'S PHARMASERV
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:DR
Authorized Official - First Name:BINCY
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:631-359-9711
Mailing Address - Street 1:230 SEA LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3900
Mailing Address - Country:US
Mailing Address - Phone:631-815-5821
Mailing Address - Fax:
Practice Address - Street 1:520 GYPSY LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1315
Practice Address - Country:US
Practice Address - Phone:330-744-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy