Provider Demographics
NPI:1558401711
Name:ALLERGY & ASTHMA ASSOCIATES OF LYNCHBURG, INC.
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES OF LYNCHBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE ANALYST
Authorized Official - Prefix:MISS
Authorized Official - First Name:TEAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-846-2244
Mailing Address - Street 1:1715 THOMSON DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1101
Mailing Address - Country:US
Mailing Address - Phone:434-846-2244
Mailing Address - Fax:434-846-0602
Practice Address - Street 1:1715 THOMSON DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1101
Practice Address - Country:US
Practice Address - Phone:434-846-2244
Practice Address - Fax:434-846-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019309174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V981A02Medicare ID - Type UnspecifiedROBERT M. MILES
VAB10080Medicare UPIN