1285737676 NPI number — AUDIOLOGY ASSOCIATES LTD

Table of content: (NPI 1285737676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285737676 NPI number — AUDIOLOGY ASSOCIATES LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AUDIOLOGY ASSOCIATES LTD
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:
1285737676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5236 MONROE ST
Provider Second Line Business Mailing Address:
UNIT C
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43623-3199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-842-0664
Provider Business Mailing Address Fax Number:
419-842-0583

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5236 MONROE ST
Provider Second Line Business Practice Location Address:
UNIT C
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43623-3199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-842-0664
Provider Business Practice Location Address Fax Number:
419-842-0583
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NASTAS
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
419-842-0664

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 374688337007 . This is a "MEDICAL MUTUAL OF OHIO LS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000139921 . This is a "ANTHEM LSN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2120725 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 640E810390 . This is a "BLUE CROSS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 05098 . This is a "NECP LSN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 540E810400 . This is a "BLUE CROSS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 03322 . This is a "PARAMOUNT LSN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 382569805004 . This is a "MEDICAL MUTUAL OF OHIO RJ" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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