Provider Demographics
NPI:1336190081
Name:ALLCARE MEDICAL TROY, PLLC
Entity Type:Organization
Organization Name:ALLCARE MEDICAL TROY, PLLC
Other - Org Name:ALLCARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-536-4624
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:TN
Mailing Address - Zip Code:38260-0188
Mailing Address - Country:US
Mailing Address - Phone:731-536-4624
Mailing Address - Fax:731-536-4905
Practice Address - Street 1:316 E HARPER ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:TN
Practice Address - Zip Code:38260-5951
Practice Address - Country:US
Practice Address - Phone:731-536-4624
Practice Address - Fax:731-536-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3380044Medicaid
TN3380044Medicaid
3380040Medicare ID - Type Unspecified