Provider Demographics
NPI:1851478390
Name:ALLERGY & ASTHMA CENTER, INC.
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAL
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-944-0847
Mailing Address - Street 1:9221 E BASELINE RD
Mailing Address - Street 2:SUITE A109-617
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-8310
Mailing Address - Country:US
Mailing Address - Phone:480-357-3904
Mailing Address - Fax:480-357-4639
Practice Address - Street 1:10443 N CAVE CREEK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-1637
Practice Address - Country:US
Practice Address - Phone:602-944-0847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4066120-00Medicaid
MD4066120-00Medicaid