Provider Demographics
NPI:1497746937
Name:REGIONAL ALLERGY & ASTHMA CONSULTANTS PA
Entity Type:Organization
Organization Name:REGIONAL ALLERGY & ASTHMA CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:ELLISTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-253-3382
Mailing Address - Street 1:14 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4104
Mailing Address - Country:US
Mailing Address - Phone:828-253-3382
Mailing Address - Fax:828-253-0069
Practice Address - Street 1:14 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4104
Practice Address - Country:US
Practice Address - Phone:828-253-3382
Practice Address - Fax:828-253-0069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0213GOtherBLUE CROSS
NC890213GMedicaid
2309660Medicare ID - Type Unspecified