Provider Demographics
NPI:1972898534
Name:ALLEN, ALISON
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 WHISKEY RD
Mailing Address - Street 2:T1310
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-8521
Mailing Address - Country:US
Mailing Address - Phone:803-644-2711
Mailing Address - Fax:803-644-2711
Practice Address - Street 1:2545 WHISKEY RD
Practice Address - Street 2:T1310
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-8521
Practice Address - Country:US
Practice Address - Phone:803-644-2711
Practice Address - Fax:803-644-2711
Is Sole Proprietor?:No
Enumeration Date:2011-06-12
Last Update Date:2011-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist