MEDICARE: AMANDAS FAMILY HEARING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist

General Provider Information

NPI Number	:	1023627692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDAS FAMILY HEARING INC

Provider Business Mailing Address
First Line	:	1701 MENTOR AVE STE 5
Second Line	:
City	:	PAINESVILLE
State	:	OH
Zip	:	44077-1459
Country	:	US
Telephone Number	:	440-357-4327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 MENTOR AVE STE 5
Second Line	:
City	:	PAINESVILLE
State	:	OH
Zip	:	44077-1459
Country	:	US
Telephone Number	:	440-357-4327
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA BARBUR
Credential	:	AUD
Telephone Number	:	440-668-9825

Provider Enumeration Date	:	07/29/2020
Last Update Date	:	07/29/2020

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