Provider Demographics
NPI:1609998293
Name:ASTHMA AND EMPHYSEMA CENTER INC
Entity Type:Organization
Organization Name:ASTHMA AND EMPHYSEMA CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-222-9053
Mailing Address - Street 1:425 W GRAND AVE
Mailing Address - Street 2:SUITE 3004
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4775
Mailing Address - Country:US
Mailing Address - Phone:937-222-9053
Mailing Address - Fax:937-222-9054
Practice Address - Street 1:425 W GRAND AVE
Practice Address - Street 2:SUITE 3004
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4775
Practice Address - Country:US
Practice Address - Phone:937-222-9053
Practice Address - Fax:937-222-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH005200207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0837947Medicaid
OH0837947Medicaid
OH0686923Medicare ID - Type Unspecified