1730425000 NPI number — ASSOCIATES IN AUDIOLOGY OF CHESTER COUNTY

Table of content: (NPI 1730425000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730425000 NPI number — ASSOCIATES IN AUDIOLOGY OF CHESTER COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN AUDIOLOGY OF CHESTER COUNTY
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:
1730425000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
407 W LINCOLN HWY
Provider Second Line Business Mailing Address:
STE 50
Provider Business Mailing Address City Name:
EXTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19341-2521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-363-1340
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
407 W LINCOLN HWY
Provider Second Line Business Practice Location Address:
STE 50
Provider Business Practice Location Address City Name:
EXTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19341-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-363-1340
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/14/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MCCANDLESS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-363-1340

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  AT006163 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: BB968Z . This is a "MEDICARE ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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