MEDICARE: BREATHE BETTER ALLERGY ASTHMA & SINUS CENTER, INC

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	207K00000X	Allergy & Immunology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821567371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREATHE BETTER ALLERGY ASTHMA & SINUS CENTER, INC

Provider Business Mailing Address
First Line	:	950 S ENOTA DR NE STE A
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2439
Country	:	US
Telephone Number	:	770-536-0470
Fax Number	:	770-536-3031

Provider Business Practice Location Address
First Line	:	950 S ENOTA DR NE STE A
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2439
Country	:	US
Telephone Number	:	770-536-0470
Fax Number	:	770-536-3031

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. MARSHA WILLIAMSON
Credential	:
Telephone Number	:	706-202-6842

Provider Enumeration Date	:	11/14/2018
Last Update Date	:	09/26/2019

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