Provider Demographics
NPI:1811753619
Name:ALLCARE CCO, INC.
Entity type:Organization
Organization Name:ALLCARE CCO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WOODIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MBA, MACC
Authorized Official - Phone:541-471-4106
Mailing Address - Street 1:1701 NE 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1319
Mailing Address - Country:US
Mailing Address - Phone:541-471-4106
Mailing Address - Fax:
Practice Address - Street 1:1701 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1319
Practice Address - Country:US
Practice Address - Phone:541-471-4106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLCARE HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization