Healthcare Provider Details
I. General information
NPI: 1487221081
Provider Name (Legal Business Name): MENM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2021
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
107 E WATTS ST
ENTERPRISE AL
36330-2511
US
IV. Provider business mailing address
8300 CENTRAL PARK DR STE 100
WACO TX
76712-6666
US
V. Phone/Fax
- Phone: 334-393-6688
- Fax:
- Phone: 254-227-6825
- Fax: 254-300-4990
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NIDIA
GARCIA
Title or Position: VP OF MARKETING
Credential:
Phone: 254-227-6825