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General NPI Number Information
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NPI Number | 1366799322
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY DISTRIBUTION, LLC
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 275 ROUTE 10 E STE 160
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1358
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Country | US
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Telephone | 561-478-8770
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Fax | 561-598-7231
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Provider Business Mailing Address
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Address Line | PO BOX 200132
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City | DALLAS
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State | TX
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Zip | 75320-0132
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Country | US
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Telephone | 561-478-8770
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING ADMINISTRATOR
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Name | JORDAN KUNKLE
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Credential |
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Telephone | 561-530-2149
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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 |
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License Number State |
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