MEDICARE: ADVANCED HEARING AID TECHNOLOGY OF AMARILLO. LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	80975	OTHER	TX	HEARING INSTRUMENT FITTER AND DISPENSER LICENSE

General Provider Information

NPI Number	:	1740875004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEARING AID TECHNOLOGY OF AMARILLO. LLC

Provider Business Mailing Address
First Line	:	3505 OLSEN BLVD STE 108
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-3035
Country	:	US
Telephone Number	:	806-355-9957
Fax Number	:	806-353-1235

Provider Business Practice Location Address
First Line	:	3505 OLSEN BLVD STE 108
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-3035
Country	:	US
Telephone Number	:	806-355-9957
Fax Number	:	806-353-1235

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. VALERIE ANN HOCKADAY
Credential	:	HIS
Telephone Number	:	806-355-9957

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	03/08/2021

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