MEDICARE: AUDIOLOGY AND HEARING ASSOCIATES

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	261QH0700X	Hearing and Speech Clinic/Center	A1063	OH
2	332S00000X	Hearing Aid Equipment	A1063	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114109436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUDIOLOGY AND HEARING ASSOCIATES

Provider Business Mailing Address
First Line	:	8700 E MARKET ST
Second Line	:	SUITE 2
City	:	WARREN
State	:	OH
Zip	:	44484-2340
Country	:	US
Telephone Number	:	330-372-4500
Fax Number	:	330-372-4540

Provider Business Practice Location Address
First Line	:	8700 E MARKET ST
Second Line	:	SUITE 2
City	:	WARREN
State	:	OH
Zip	:	44484-2340
Country	:	US
Telephone Number	:	330-372-4500
Fax Number	:	330-372-4540

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LARRY D. GIOVINAZZO
Credential	:	AU.D.
Telephone Number	:	330-372-4500

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	03/19/2008

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