Allergy & Asthma Clinics of Ga
Organization Active NPI Specialist · Albany, GA
NPI 1093997447 · NPPES record last updated Feb 25, 2008
Key facts
- NPI
- 1093997447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- ALLERGY & ASTHMA CLINICS OF GA
- Practice address
- 105 Spanish CT
Albany, GA 31707-1282 - Phone
- (229) 438-7100
- Fax
- (229) 438-9382
- NPI assigned
- Nov 28, 2007
- Organization subpart
- No
Authorized official
- Name
- T. Alan Moree, C.P.A.
- Title
- Administrator
- Phone
- (229) 438-7100
Practitioners 12
-
Mary E. Webb, NP
-
Nancy L McKemie, PA
-
Fauzia K Durrani, MD
-
Rahul Kumar Vangala, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040413000951 | GA | Part B Supplier - Clinic/Group Practice | 1052305919 |
Receives reassigned benefits from 8 practitioners Practice locations: Albany, GA |
National Provider Directory
Locations
105 Spanish Ct
Albany, GA 31707
Phone (229) 438-7100
1038 E Forsyth St
Ste B
Americus, GA 31709
Phone (229) 924-3177
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
105 Spanish CT
Albany, GA 31707-1282
Mailing address
105 Spanish CT
Albany, GA 31707-1282
Phone (229) 438-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386749117 | Other | GA | NPI |
| 1114017449 | Other | NPI |
Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.