1063471860 NPI number — ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES P.C.

Table of content: (NPI 1063471860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063471860 NPI number — ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES P.C.
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:
1063471860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
09/09/2022
NPI Reactivation Date:
10/09/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2808 S 80 AVE
Provider Second Line Business Mailing Address:
STE 210
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68124-3253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-391-1800
Provider Business Mailing Address Fax Number:
402-391-1563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2808 S 80 AVE
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68124-1563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-391-1800
Provider Business Practice Location Address Fax Number:
402-391-1563
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUEHN
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
REVENUE CYCLE MANAGER
Authorized Official Telephone Number:
402-391-1800

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)





Copyright © 2007-2025 www.npivalidator.com