Healthcare Provider Details

I. General information

NPI: 1801053400
Provider Name (Legal Business Name): KNAPP HEARING AID CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 FAIRMONT RD STE 106
WESTOVER WV
26501-3892
US

IV. Provider business mailing address

1400 JOHNSON AVE STE 4N
BRIDGEPORT WV
26330-1063
US

V. Phone/Fax

Practice location:
  • Phone: 304-296-3357
  • Fax: 304-296-8044
Mailing address:
  • Phone: 304-842-3050
  • Fax: 304-842-5733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAT-005891
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberA-0177
License Number StateWV

VIII. Authorized Official

Name: MS. JANET M PETITTE
Title or Position: AUDIOLOGIST
Credential: M.S. CCC/A
Phone: 304-842-3050