Organization
ALLEGIANT HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMICA SMITH (OWNER)
(804) 569-0765
Entity
Organization
Contact information
Practice address
419 KEITHWOOD CT, NORTH CHESTERFIELD, VA 23236-3059
(804) 596-0765
(804) 368-1432
Mailing address
419 KEITHWOOD CT, NORTH CHESTERFIELD, VA 23236-3059
(804) 596-0765
(804) 368-1432
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1296420
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164889765
—
VA
Enumeration date
08/22/2014
Last updated
08/22/2014
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