Provider Demographics
NPI:1952122061
Name:ALLONE HEALTHCARE LLC
Entity type:Organization
Organization Name:ALLONE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUMEN
Authorized Official - Middle Name:ANTONIEV
Authorized Official - Last Name:PETKOV
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR/L
Authorized Official - Phone:651-442-5094
Mailing Address - Street 1:5168 W AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1469
Mailing Address - Country:US
Mailing Address - Phone:651-442-5094
Mailing Address - Fax:
Practice Address - Street 1:3240 E UNION HILLS DR STE 151
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-2652
Practice Address - Country:US
Practice Address - Phone:651-442-5094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy