Provider Demographics
NPI:1841222841
Name:ALLEGHANY HEALTH SERVICES
Entity Type:Organization
Organization Name:ALLEGHANY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-372-5511
Mailing Address - Street 1:233 DOCTORS ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675-9247
Mailing Address - Country:US
Mailing Address - Phone:336-372-3110
Mailing Address - Fax:336-372-7971
Practice Address - Street 1:233 DOCTORS ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-9247
Practice Address - Country:US
Practice Address - Phone:336-372-3110
Practice Address - Fax:336-372-7971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0175WOtherBCBS OF NC
NC5902704Medicaid
NCJ545OtherPARTNERS MEDICARE CHOICE
NC5902704Medicaid
NC=========OtherCOMMERCIAL
NC=========OtherUNITED HEALTHCARE
NCJ545OtherPARTNERS MEDICARE CHOICE