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General NPI Number Information
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NPI Number | 1174765606
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Entity Type | Organization
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Legal Business Name | RED HAT AUDIOLOGY, INC.
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 3836 INTERNATIONAL DR LEISURE WORLD PLAZA
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City | SILVER SPRING
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State | MD
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Zip | 20906-1548
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Country | US
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Telephone | 301-438-3280
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Fax | 301-438-3282
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Provider Business Mailing Address
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Address Line | 3836 INTERNATIONAL DR LEISURE WORLD PLAZA
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City | SILVER SPRING
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State | MD
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Zip | 20906-1548
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Country | US
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Telephone | 301-438-3280
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Fax | 301-438-3282
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | DR. GWYNETH WAGNER NEWCOMB
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Credential | AU.D.
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Telephone | 301-438-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 00382
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License Number State | MD
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