Healthcare Provider Details

I. General information

NPI: 1922864321
Provider Name (Legal Business Name): MENM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 PARK MARINA DR STE 105
REDDING CA
96001-0961
US

IV. Provider business mailing address

8300 CENTRAL PARK DR STE 100
WACO TX
76712-6666
US

V. Phone/Fax

Practice location:
  • Phone: 530-390-9764
  • Fax:
Mailing address:
  • Phone: 254-227-6825
  • Fax: 254-300-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: NIDIA GARCIA
Title or Position: VP OF MARKETING
Credential:
Phone: 254-227-6825