Provider Demographics
NPI:1285723593
Name:CAROLINA ALLERGY & ASTHMA CONSULTANTS
Entity type:Organization
Organization Name:CAROLINA ALLERGY & ASTHMA CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-765-9233
Mailing Address - Street 1:ONE RICHLAND MEDICAL PARK
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-765-9233
Mailing Address - Fax:803-779-0344
Practice Address - Street 1:ONE RICHLAND MEDICAL PARK
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-765-9233
Practice Address - Fax:803-779-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1591Medicaid
SC5396Medicare PIN
SCE124515396Medicare PIN