Provider Demographics
NPI:1265658132
Name:ALLERGY CENTER, PA
Entity Type:Organization
Organization Name:ALLERGY CENTER, PA
Other - Org Name:EASTERN CAROLINA ALLERGY, ASTHMA AND IMMUNOLOGY, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MEHLHOP
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:252-321-8683
Mailing Address - Street 1:2395 HEMBY LN.
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-321-8683
Mailing Address - Fax:252-329-8686
Practice Address - Street 1:2395 HEMBY LN.
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-321-8683
Practice Address - Fax:252-329-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2331919Medicare ID - Type Unspecified