Provider Demographics
NPI:1710021811
Name:ABC PEDIATRICS OF ASHEVILLE PA
Entity type:Organization
Organization Name:ABC PEDIATRICS OF ASHEVILLE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPANY PRESIDENT/OWNER 20 PERCENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:PASCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-277-3000
Mailing Address - Street 1:64 PEACHTREE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3121
Mailing Address - Country:US
Mailing Address - Phone:828-277-3000
Mailing Address - Fax:828-277-3636
Practice Address - Street 1:64 PEACHTREE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3121
Practice Address - Country:US
Practice Address - Phone:828-277-3000
Practice Address - Fax:828-277-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208000000X
NC125733208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017MAOtherBCBSNC
NC590240Medicaid
NC5902540Medicaid