MEDICARE: SUSAN DENNEY H.A.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	2281	AL

General Provider Information

NPI Number	:	1194170472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN DENNEY H.A.S.

Provider Business Mailing Address
First Line	:	8050 N 9TH AVE APT 49
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6464
Country	:	US
Telephone Number	:	205-294-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 FORREST AVE
Second Line	:
City	:	EAST BREWTON
State	:	AL
Zip	:	36426-2520
Country	:	US
Telephone Number	:	251-314-1216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2016
Last Update Date	:	04/25/2016

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