Provider Demographics
NPI:1760783765
Name:SOUTH CAROLINA ASTHMA ALLIANCE
Entity Type:Organization
Organization Name:SOUTH CAROLINA ASTHMA ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-237-0031
Mailing Address - Street 1:PO BOX 14184
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29610-4184
Mailing Address - Country:US
Mailing Address - Phone:864-237-0031
Mailing Address - Fax:
Practice Address - Street 1:22 DELL CIR
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-8765
Practice Address - Country:US
Practice Address - Phone:864-237-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-07
Last Update Date:2010-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management