=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871625053
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUDIPHONE CO OF PARMA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6363 YORK RD SUITE 102
-----------------------------------------------------
City | PARMA HTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-888-5445
-----------------------------------------------------
Fax | 440-888-4185
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6363 YORK RD SUITE 102
-----------------------------------------------------
City | PARMA HTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-888-5445
-----------------------------------------------------
Fax | 440-888-4185
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. JANE M MACKALL
-----------------------------------------------------
Credential | MA CCC A
-----------------------------------------------------
Telephone | 440-888-5445
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------