Healthcare Provider Details

I. General information

NPI: 1881851830
Provider Name (Legal Business Name): ASHBROOK AUDIOLOGY AND HEARING AID CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SPRUCE ST
MARTINSVILLE VA
24112-4508
US

IV. Provider business mailing address

1111 SPRUCE STREET
MARTINSVILLE VA
24112-4508
US

V. Phone/Fax

Practice location:
  • Phone: 276-666-0401
  • Fax: 276-666-0045
Mailing address:
  • Phone: 276-666-0401
  • Fax: 276-666-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2101001212
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001180
License Number StateVA

VIII. Authorized Official

Name: DEBORAH HARRIS KENDRICK
Title or Position: FRONT OFFICE MANAGER
Credential:
Phone: 276-666-0401