Healthcare Provider Details

I. General information

NPI: 1275690497
Provider Name (Legal Business Name): MAICO AUDIOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 THIMBLE SHOALS BLVD STE C-3
NEWPORT NEWS VA
23606-2576
US

IV. Provider business mailing address

149 PLANTATION RIDGE DR STE 140
MOORESVILLE NC
28117-9175
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-8794
  • Fax:
Mailing address:
  • Phone: 704-360-4788
  • Fax: 704-251-6746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOEL PARKER
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 479-422-6890