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Organization

ALLEN INTENSIVIST GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISHA FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization

Contact information

Practice address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(419) 228-3335
(419) 226-5013
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
363A00000X
Physician Assistant
363LC0200X
Critical Care Medicine Nurse Practitioner

Other

Enumeration date
07/06/2022
Last updated
07/06/2022
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