Healthcare Provider Details

I. General information

NPI: 1689670648
Provider Name (Legal Business Name): AUDIOLOGY AND HEARING AID SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N KEEL RIDGE RD
HERMITAGE PA
16148-3440
US

IV. Provider business mailing address

100 N KEEL RIDGE RD
HERMITAGE PA
16148-3440
US

V. Phone/Fax

Practice location:
  • Phone: 800-471-8592
  • Fax:
Mailing address:
  • Phone: 800-471-8592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberF03245
License Number StatePA

VIII. Authorized Official

Name: JOHN BALKO
Title or Position: OWNER
Credential:
Phone: 800-471-8592