Provider Demographics
NPI:1336321124
Name:ALLIED HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:ALLIED HEALTH CARE SERVICES
Other - Org Name:ALLIED SERVICES PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST VP PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D,MBA,BCGP
Authorized Official - Phone:570-340-6450
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:18411-2260
Mailing Address - Country:US
Mailing Address - Phone:570-340-6450
Mailing Address - Fax:570-702-8747
Practice Address - Street 1:100 ABINGTON EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2260
Practice Address - Country:US
Practice Address - Phone:570-340-6450
Practice Address - Fax:570-702-8747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BN1400X, 333600000X, 3336C0004X
PAPP4817753336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2082478OtherPK
PA1000002910069Medicaid