Healthcare Provider Details

I. General information

NPI: 1073639357
Provider Name (Legal Business Name): NEWBORN HEARING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S NEW BALLAS RD
SAINT LOUIS MO
63141-8221
US

IV. Provider business mailing address

9888 OLD WARSON RD
SAINT LOUIS MO
63124-1068
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-4847
  • Fax:
Mailing address:
  • Phone: 314-251-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: KAY PARK
Title or Position: AUDIOLOGIST-MANAGER
Credential: MS
Phone: 314-251-4847