1366740524 NPI number — ALLERGY & ASTHMA CARE INC

Table of content: (NPI 1366740524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366740524 NPI number — ALLERGY & ASTHMA CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY & ASTHMA CARE INC
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:
1366740524
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:
422 RAY NORRISH DR # 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45246-1520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-671-0799
Provider Business Mailing Address Fax Number:
513-671-0845

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
422 RAY NORRISH DR # 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45246-1520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-671-6707
Provider Business Practice Location Address Fax Number:
513-671-6710
Provider Enumeration Date:
03/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BUCHER
Authorized Official First Name:
SALLY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
513-671-6707

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201015660 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3138018 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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