MEDICARE: ASTHMA AND EMPHYSEMA 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	207RP1001X	Pulmonary Disease Physician	005200	OH

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	:	1609998293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTHMA AND EMPHYSEMA CENTER INC

Provider Business Mailing Address
First Line	:	425 W GRAND AVE
Second Line	:	SUITE 3004
City	:	DAYTON
State	:	OH
Zip	:	45405-4775
Country	:	US
Telephone Number	:	937-222-9053
Fax Number	:	937-222-9054

Provider Business Practice Location Address
First Line	:	425 W GRAND AVE
Second Line	:	SUITE 3004
City	:	DAYTON
State	:	OH
Zip	:	45405-4775
Country	:	US
Telephone Number	:	937-222-9053
Fax Number	:	937-222-9054

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT A. CAIN
Credential	:	D.O.
Telephone Number	:	937-222-9053

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	08/22/2007

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