MEDICARE: CENTRAL PENNSYLVANIA ASTHMA AND ALLERGY CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD015039E	PA

General Provider Information

NPI Number	:	1083730857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL PENNSYLVANIA ASTHMA AND ALLERGY CARE, LLC

Provider Business Mailing Address
First Line	:	800 S LOGAN BLVD STE 3200
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-3050
Country	:	US
Telephone Number	:	814-944-2097
Fax Number	:	814-941-2303

Provider Business Practice Location Address
First Line	:	800 S LOGAN BLVD STE 3200
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-3050
Country	:	US
Telephone Number	:	814-944-2097
Fax Number	:	814-941-2303

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY ROSCH
Credential	:
Telephone Number	:	814-944-2097

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	06/23/2020

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