Provider Demographics
NPI:1528033263
Name:ALLERGY & ASTHMA CONSULTANTS, LLP
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CONSULTANTS, LLP
Other - Org Name:CHARLESTON ALLERGY & ASTHMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/ MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:DEVON
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-881-2030
Mailing Address - Street 1:180 WINGO WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3235
Mailing Address - Country:US
Mailing Address - Phone:843-881-2030
Mailing Address - Fax:843-881-6249
Practice Address - Street 1:180 WINGO WAY STE 102
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-1810
Practice Address - Country:US
Practice Address - Phone:843-881-2030
Practice Address - Fax:843-881-6249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1473Medicaid
SCGP1473Medicaid