Healthcare Provider Details

I. General information

NPI: 1811040140
Provider Name (Legal Business Name): OGDEN AUDIOLOGY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5349 ADAMS AVE PKWY STE C
OGDEN UT
84405-4736
US

IV. Provider business mailing address

5349 ADAMS AVE PKWY
OGDEN UT
84405-4736
US

V. Phone/Fax

Practice location:
  • Phone: 801-479-0725
  • Fax: 801-479-0725
Mailing address:
  • Phone: 801-479-3346
  • Fax: 801-479-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number103819-4101
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number103819-4101
License Number StateUT

VIII. Authorized Official

Name: KEVIN T HARWARD
Title or Position: OWNER/AUDIOLOGIST
Credential: AUD
Phone: 801-479-3346