# WV ASTHMA AND ALLERGY CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Asthma and Allergy Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588916399
- **Authorized official:** MR. JIM A MATHENA (ADMINISTRATOR)
- **Authorized official phone:** (304) 343-4300

## Contact information

- **Practice address:** 401 6TH AVE, SUITE 303D, MONTGOMERY, WV 25136-2116
- **Practice address phone:** (304) 343-4300
- **Practice address fax:** (304) 343-5473
- **Mailing address:** 208 MACCORKLE AVE SE, CHARLESTON, WV 25314-1160
- **Mailing address phone:** (304) 343-4300
- **Mailing address fax:** (304) 343-5473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | 78687 | WV | Yes |

## Other

- **Enumeration date:** 10/04/2012
- **Last updated:** 10/04/2012