Healthcare Provider Details

I. General information

NPI: 1518240407
Provider Name (Legal Business Name): FREDERICK HEARING CENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 DELAWARE RD
FREDERICK MD
21701-4618
US

IV. Provider business mailing address

310 DELAWARE RD
FREDERICK MD
21701-4618
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-0553
  • Fax: 301-663-4189
Mailing address:
  • Phone: 301-663-0553
  • Fax: 301-663-4189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: LORI BARR
Title or Position: OWNER
Credential:
Phone: 301-663-0553