Provider Demographics
NPI:1588670343
Name:ALLERGY & ASTHMA CARE OF INDIANA
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CARE OF INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRICK
Authorized Official - Middle Name:P
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-708-2839
Mailing Address - Street 1:11590 N MERIDIAN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4599
Mailing Address - Country:US
Mailing Address - Phone:317-708-2839
Mailing Address - Fax:317-708-2877
Practice Address - Street 1:11590 N MERIDIAN ST STE 400
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4599
Practice Address - Country:US
Practice Address - Phone:317-708-2839
Practice Address - Fax:317-708-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042528174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1700889722OtherNPI
IN1275536203OtherNPI
IN1013910033OtherNPI