Healthcare Provider Details

I. General information

NPI: 1326182189
Provider Name (Legal Business Name): MODERNHEARINGAIDCENTERINC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 11TH AVE S
BIRMINGHAM AL
35205-2618
US

IV. Provider business mailing address

1900 11TH AVE S
BIRMINGHAM AL
35205-2618
US

V. Phone/Fax

Practice location:
  • Phone: 205-322-4272
  • Fax: 205-323-3228
Mailing address:
  • Phone: 205-322-4272
  • Fax: 205-323-3228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4009
License Number StateAL

VIII. Authorized Official

Name: MR. EDMUND D WEST
Title or Position: PRESIDENT
Credential:
Phone: 205-322-4272