Healthcare Provider Details

I. General information

NPI: 1497300016
Provider Name (Legal Business Name): TRI-STATE HEARING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2019
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 6TH AVE
HUNTINGTON WV
25701-2306
US

IV. Provider business mailing address

906 6TH AVE
HUNTINGTON WV
25701-2306
US

V. Phone/Fax

Practice location:
  • Phone: 304-948-5565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: REBECCA ANN BRASHEARS
Title or Position: AUDIOLOGIST
Credential:
Phone: 304-948-5565