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General NPI Number Information
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NPI Number | 1508912924
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Entity Type | Organization
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Legal Business Name | CHAC INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 115 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32502-4838
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Country | US
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Telephone | 850-438-4092
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Fax | 850-438-4095
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Provider Business Mailing Address
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Address Line | 115 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32502-4838
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Country | US
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Telephone | 850-438-4092
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Fax | 850-438-4095
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MS. PATRICIA J RUSSO
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Credential | BC-HIS
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Telephone | 850-438-4092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY1294
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AY1294
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS 1379
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 235500000X
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Taxonomy Name | Speech/Language/Hearing Specialist/Technologist
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License Number | AY1294
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 235500000X
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Taxonomy Name | Speech/Language/Hearing Specialist/Technologist
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License Number | AS 1379
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | AS 1379
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | AY1294
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | AS 1379
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License Number State | FL
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