Healthcare Provider Details

I. General information

NPI: 1861650335
Provider Name (Legal Business Name): ALLERGY & ASTHMA CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS PARAGON MEDICAL BUILDING SUITE 202
ST THOMAS VI
00802-2615
US

IV. Provider business mailing address

P.O. BOX 595
ST. THOMAS VIRGIN ISLANDS
00804
UM

V. Phone/Fax

Practice location:
  • Phone: 340-776-5507
  • Fax: 340-776-7935
Mailing address:
  • Phone: 340-776-5507
  • Fax: 340-776-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberVI717
License Number StateVI

VIII. Authorized Official

Name: AUDRIA THOMAS
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 340-776-5507