Healthcare Provider Details

I. General information

NPI: 1407164098
Provider Name (Legal Business Name): SOUTH CITY HEARING & AUDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 WATSON RD STE 201
SAINT LOUIS MO
63109-1251
US

IV. Provider business mailing address

3915 WATSON RD STE 201
SAINT LOUIS MO
63109-1251
US

V. Phone/Fax

Practice location:
  • Phone: 314-647-3277
  • Fax: 314-558-9199
Mailing address:
  • Phone: 314-647-3277
  • Fax: 314-558-9199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number2000167737
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NANCY M RICHMAN
Title or Position: MANAGING MEMBER
Credential: AU.D.
Phone: 314-647-3277