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General NPI Number Information
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NPI Number | 1760826549
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY DISTRIBUTION
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 04/23/2013
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Provider Practice Location Address
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Address Line | 3200 WEST MARKET STREET
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City | AKRON
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State | OH
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Zip | 44333-3324
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Country | US
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Telephone | 330-869-9911
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Fax | 330-622-4490
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Provider Business Mailing Address
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Address Line | 10455 RIVERSIDE DR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4237
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Country | US
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Telephone | 561-478-8770
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Fax | 561-598-7230
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Authorized Official
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Title or Position | CONTRACTING MANAGER
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Name | LILLIAN MORALES
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Credential |
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Telephone | 561-478-8770
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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 | 03102
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License Number State | OH
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