Provider Demographics
NPI:1215763198
Name:ALLIED CARE FAMILY PRACTICE LLC
Entity type:Organization
Organization Name:ALLIED CARE FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-247-7868
Mailing Address - Street 1:330 S 5TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5861
Mailing Address - Country:US
Mailing Address - Phone:405-322-5056
Mailing Address - Fax:405-342-0922
Practice Address - Street 1:330 S 5TH ST STE 206
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5861
Practice Address - Country:US
Practice Address - Phone:877-247-7868
Practice Address - Fax:405-342-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty