Provider Demographics
NPI:1437316056
Name:ALABAMA ALLERGY & ASTHMA CARE, LLC
Entity Type:Organization
Organization Name:ALABAMA ALLERGY & ASTHMA CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-890-0311
Mailing Address - Street 1:101 WESTOVER CIR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-4900
Mailing Address - Country:US
Mailing Address - Phone:256-890-0331
Mailing Address - Fax:256-325-1189
Practice Address - Street 1:101 WESTOVER CIR
Practice Address - Street 2:SUITE C
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-4900
Practice Address - Country:US
Practice Address - Phone:256-890-0331
Practice Address - Fax:256-325-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025205207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1952373805OtherNPI FOR SINGLE OFFICE
AL529928730Medicaid
051516102KRIMedicare PIN
AL529928730Medicaid