MEDICARE: AUDIO-LOGIC, PC

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	237600000X	Audiologist-Hearing Aid Fitter	96	NE

General Provider Information

NPI Number	:	1134314305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUDIO-LOGIC, PC

Provider Business Mailing Address
First Line	:	3763 39TH AVE
Second Line	:	SUITE 300
City	:	COLUMBUS
State	:	NE
Zip	:	68601-4504
Country	:	US
Telephone Number	:	402-564-9198
Fax Number	:	402-564-9821

Provider Business Practice Location Address
First Line	:	3763 39TH AVE
Second Line	:	SUITE 300
City	:	COLUMBUS
State	:	NE
Zip	:	68601-4504
Country	:	US
Telephone Number	:	402-564-9198
Fax Number	:	402-564-9821

Authorized Official
Title or Position	:	AUDIOLOGIST
Name	:	MRS. NORA L FUCHS
Credential	:	AUD, CCC-A
Telephone Number	:	402-564-9198

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	11/12/2009

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