Healthcare Provider Details

I. General information

NPI: 1891366944
Provider Name (Legal Business Name): ADVANCED HEARING SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21641 FARMERS LN
JETERSVILLE VA
23083-2850
US

IV. Provider business mailing address

21641 FARMERS LN
JETERSVILLE VA
23083-2850
US

V. Phone/Fax

Practice location:
  • Phone: 804-539-1217
  • Fax:
Mailing address:
  • Phone: 804-539-1217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS A CASEY
Title or Position: PRESIDENT
Credential: M.S.
Phone: 804-539-1217