Healthcare Provider Details

I. General information

NPI: 1942071279
Provider Name (Legal Business Name): MENM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

864 E HIGHWAY 60 STE C
MONETT MO
65708-8291
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 417-354-0626
  • 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 TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 3
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