Healthcare Provider Details

I. General information

NPI: 1649086125
Provider Name (Legal Business Name): JULIE VARGUS HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/11/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 RT 6A # MA-6A
ORLEANS MA
02653-2411
US

IV. Provider business mailing address

860 ROUTE 134 STE 1
SOUTH DENNIS MA
02660-2577
US

V. Phone/Fax

Practice location:
  • Phone: 508-255-1285
  • Fax:
Mailing address:
  • Phone: 508-255-1285
  • Fax: 978-254-0513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHES6569
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: