Provider Demographics
NPI:1841372604
Name:CENTRAL ALLERGY CARE PC
Entity type:Organization
Organization Name:CENTRAL ALLERGY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-721-3100
Mailing Address - Street 1:1034 S BRENTWOOD BLVD STE 460
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1249
Mailing Address - Country:US
Mailing Address - Phone:314-721-3100
Mailing Address - Fax:314-721-3535
Practice Address - Street 1:1034 S BRENTWOOD BLVD STE 460
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1249
Practice Address - Country:US
Practice Address - Phone:314-721-3100
Practice Address - Fax:314-721-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOG07376Medicare UPIN
MO000014096Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER