MEDICARE: MENM, 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	237600000X	Audiologist-Hearing Aid Fitter

General Provider Information

NPI Number	:	1982317327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENM, LLC

Provider Business Mailing Address
First Line	:	8300 CENTRAL PARK DR STE 100
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-6666
Country	:	US
Telephone Number	:	805-238-1078
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 SPRING ST STE A
Second Line	:
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-2167
Country	:	US
Telephone Number	:	805-238-1078
Fax Number	:

Authorized Official
Title or Position	:	ME FLAGSHIP
Name	:	NIDIA GARCIA
Credential	:
Telephone Number	:	254-227-6825

Provider Enumeration Date	:	12/30/2022
Last Update Date	:	06/22/2023

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