Provider Demographics
NPI:1104342815
Name:ALLIED HOSPICE, LLC
Entity type:Organization
Organization Name:ALLIED HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CROSBY
Authorized Official - Middle Name:CONNOR
Authorized Official - Last Name:CAUGHRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-457-8120
Mailing Address - Street 1:500 N POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-2337
Mailing Address - Country:US
Mailing Address - Phone:918-742-4269
Mailing Address - Fax:918-742-4493
Practice Address - Street 1:500 N POPLAR AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-2337
Practice Address - Country:US
Practice Address - Phone:918-742-4269
Practice Address - Fax:918-742-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based