1821098062 NPI number — AUDIOLOGY HEARING AID ASSOCIATES, INC.

Table of content: (NPI 1821098062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821098062 NPI number — AUDIOLOGY HEARING AID ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AUDIOLOGY HEARING AID ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821098062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2104 LANGHORNE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNCHBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24501-1424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-528-4245
Provider Business Mailing Address Fax Number:
434-528-3685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2104 LANGHORNE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24501-1424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-528-4245
Provider Business Practice Location Address Fax Number:
434-528-3685
Provider Enumeration Date:
07/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GNEWIKOW
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
434-799-6288

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  5775 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 149510300 . This is a "DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5401361858 . This is a "PRIMARY PHYSICIAN CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5775 . This is a "BUSINESS LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 27602 . This is a "SOUTHERN HEALTH SERVICES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 18786 . This is a "OPTIMA FAMILY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 57750 . This is a "ANTHEM OF VIRGINIA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com