Healthcare Provider Details

I. General information

NPI: 1053402750
Provider Name (Legal Business Name): ASSOCIATED HEARINGS & DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6719 GOVERNOR GC PEERY HWY STE 2500
RICHLANDS VA
24641-2489
US

IV. Provider business mailing address

6719 GOVERNOR GC PEERY HWY STE 2500
RICHLANDS VA
24641-2489
US

V. Phone/Fax

Practice location:
  • Phone: 276-964-7465
  • Fax: 276-963-3507
Mailing address:
  • Phone: 276-964-7465
  • Fax: 276-963-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2102002260
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201001303
License Number StateVA

VIII. Authorized Official

Name: MICHELLE ANNETTE VARNEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 276-964-7465