Provider Demographics
NPI:1760472146
Name:ALLERGY PARTNERS, PLLC
Entity Type:Organization
Organization Name:ALLERGY PARTNERS, PLLC
Other - Org Name:ALLERGY PARTNERS OF CEDAR RAPIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-277-1300
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:3500 MOUNT VERNON RD SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-3864
Practice Address - Country:US
Practice Address - Phone:319-366-6249
Practice Address - Fax:319-366-6244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1760472146Medicaid
IAI3415OtherMEDICARE PTAN
IA0050OtherMIDLANDS CHOICE
IAI3415OtherMEDICARE PTAN
IA=========0000EOtherUNITED HEALTH CARE RIVER
IAI3415OtherMEDICARE PTAN
IACH9156Medicare PIN