Provider Demographics
NPI:1851398341
Name:ALLIED SERVICES SKILLED NURSING CENTER
Entity Type:Organization
Organization Name:ALLIED SERVICES SKILLED NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP PATIENT FINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SPLENDIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-341-4699
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:570-348-1364
Mailing Address - Fax:
Practice Address - Street 1:303 SMALLACOMBE DR
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2634
Practice Address - Country:US
Practice Address - Phone:570-348-1424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA011902314000000X
PA332BC3200X, 332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA812502OtherAETNA
PA000000079091Other3 RIVERS
PAA08008623OtherCEDI/SUBMITTER ID
PA0011577000002Medicaid
PA30968OtherGEISINGER
PA2029560002Medicare NSC
PA396074Medicare Oscar/Certification