MEDICARE: ALLERVIE HEALTH PROFESSIONAL CORPORATION

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	:	1780629535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERVIE HEALTH PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	504 BROOKWOOD BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6802
Country	:	US
Telephone Number	:	205-871-9661
Fax Number	:	205-870-1621

Provider Business Practice Location Address
First Line	:	504 BROOKWOOD BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6802
Country	:	US
Telephone Number	:	205-871-9661
Fax Number	:	205-870-1621

Authorized Official
Title or Position	:	RCM BUSINESS PARTNER
Name	:	LILY FLYNN
Credential	:
Telephone Number	:	469-209-8355

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	10/24/2023

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