Provider Demographics
NPI:1144503913
Name:WILLIAM M. ALLEN, JR. LPN
Entity type:Organization
Organization Name:WILLIAM M. ALLEN, JR. LPN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPN
Authorized Official - Phone:937-678-1354
Mailing Address - Street 1:1005 N COMMERCE ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:LEWISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45338-9801
Mailing Address - Country:US
Mailing Address - Phone:937-678-1354
Mailing Address - Fax:
Practice Address - Street 1:1005 N COMMERCE ST
Practice Address - Street 2:APT. 4
Practice Address - City:LEWISBURG
Practice Address - State:OH
Practice Address - Zip Code:45338-9801
Practice Address - Country:US
Practice Address - Phone:937-678-1354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN107462251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care