MEDICARE: ECHO HEARING SYSTEMS AND AUDIOLOGY OF CLEVELAND, 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	A00841	OH

General Provider Information

NPI Number	:	1134536543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECHO HEARING SYSTEMS AND AUDIOLOGY OF CLEVELAND, INC

Provider Business Mailing Address
First Line	:	4807 ROCKSIDE RD
Second Line	:	#400
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2192
Country	:	US
Telephone Number	:	216-642-8228
Fax Number	:

Provider Business Practice Location Address
First Line	:	4807 ROCKSIDE RD
Second Line	:	#400
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2192
Country	:	US
Telephone Number	:	216-642-8228
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF AUDIOLOGY/OWNER
Name	:	DR. MARVIN J LEWIS
Credential	:	AU. D.
Telephone Number	:	216-642-8228

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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