1952468381 NPI number — ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES LTD

Table of content: (NPI 1952468381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952468381 NPI number — ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952468381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7514 E MONTEREY WAY
Provider Second Line Business Mailing Address:
STE 1
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85251-6900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-949-7377
Provider Business Mailing Address Fax Number:
480-949-8339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7514 E MONTEREY WAY
Provider Second Line Business Practice Location Address:
STE1
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85251-6900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-949-7377
Provider Business Practice Location Address Fax Number:
480-949-8339
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MANNING
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
480-949-7377

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  17209 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZWCHMS . This is a "MEDICARE GROUP ID #" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 113358 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 626202 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 218166 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 873415 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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