Healthcare Provider Details

I. General information

NPI: 1124896212
Provider Name (Legal Business Name): MIDWEST AUDIOLOGY AND HEARING AIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 1ST AVE NE STE 2
LE MARS IA
51031-3594
US

IV. Provider business mailing address

506 JACE RD
SERGEANT BLUFF IA
51054-8803
US

V. Phone/Fax

Practice location:
  • Phone: 712-898-8264
  • Fax:
Mailing address:
  • Phone: 712-389-0409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: MEGAN MARIE WEGHER
Title or Position: AUDIOLOGIST/OWNER
Credential: AUD, CCC-A
Phone: 712-389-0409