Provider Demographics
NPI:1831151232
Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEETHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-464-5969
Mailing Address - Street 1:600 N COTNER BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2343
Mailing Address - Country:US
Mailing Address - Phone:402-464-5969
Mailing Address - Fax:402-464-3657
Practice Address - Street 1:600 N COTNER BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2343
Practice Address - Country:US
Practice Address - Phone:402-464-5969
Practice Address - Fax:402-464-3657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2022-10-13
Deactivation Date:2022-09-09
Deactivation Code:
Reactivation Date:2022-10-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE97584KIMedicare ID - Type Unspecified
NED05094Medicare UPIN