1508927674 NPI number — DR. HOLLE LYNN AUNGST AUD

Table of content: DR. HOLLE LYNN AUNGST AUD (NPI 1508927674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508927674 NPI number — DR. HOLLE LYNN AUNGST AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AUNGST
Provider First Name:
HOLLE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITAKER
Provider Other First Name:
HOLLE
Provider Other Middle Name:
AUNGST
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
AUD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508927674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9500 EUCLID AVE # A-71
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44195-2234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-444-7975
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 EUCLID AVE # A-71
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195-2022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-444-7975
Provider Business Practice Location Address Fax Number:
407-649-8869
Provider Enumeration Date:
12/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  A.00413 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 086809400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 086809401 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0139588 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".