Provider Demographics
NPI:1962488155
Name:ALLEN'S MEDICAL PHARMACY, INC.
Entity Type:Organization
Organization Name:ALLEN'S MEDICAL PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-772-5180
Mailing Address - Street 1:215 OLD EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3462
Mailing Address - Country:US
Mailing Address - Phone:740-772-5180
Mailing Address - Fax:740-772-5483
Practice Address - Street 1:215 OLD EASTERN AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3462
Practice Address - Country:US
Practice Address - Phone:740-772-5180
Practice Address - Fax:740-772-5483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0512850333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0124752Medicaid
OH0124752Medicaid