Provider Demographics
NPI:1730151721
Name:THE ASTHMA & ALLERGY CENTER PC
Entity type:Organization
Organization Name:THE ASTHMA & ALLERGY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-592-2055
Mailing Address - Street 1:3503 SAMSON WAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4303
Mailing Address - Country:US
Mailing Address - Phone:402-592-2055
Mailing Address - Fax:402-592-2419
Practice Address - Street 1:3503 SAMSON WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4303
Practice Address - Country:US
Practice Address - Phone:402-592-2055
Practice Address - Fax:402-592-2419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE=========OtherTRICARE GROUP PROVIDER
NE=========13Medicaid