Provider Demographics
NPI:1396994802
Name:COVENANT ALLERGY AND ASTHMA CARE PLLC
Entity type:Organization
Organization Name:COVENANT ALLERGY AND ASTHMA CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RASCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-468-3267
Mailing Address - Street 1:1350 MACKEY BRANCH DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3482
Mailing Address - Country:US
Mailing Address - Phone:423-468-3267
Mailing Address - Fax:423-468-3270
Practice Address - Street 1:1350 MACKEY BRANCH DR
Practice Address - Street 2:SUITE 114
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3482
Practice Address - Country:US
Practice Address - Phone:423-468-3267
Practice Address - Fax:423-468-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty