MEDICARE: ALEXANDRIA AUDIOLOGY SERVICES & DISCOUNT HEARING AIDS, 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	237600000X	Audiologist-Hearing Aid Fitter	709	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1415821	OTHER	LA	KID MED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275547655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDRIA AUDIOLOGY SERVICES & DISCOUNT HEARING AIDS, INC.

Provider Business Mailing Address
First Line	:	1605 MURRAY ST
Second Line	:	SUITE 202
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-6890
Country	:	US
Telephone Number	:	318-442-7303
Fax Number	:	318-442-7094

Provider Business Practice Location Address
First Line	:	1605 MURRAY ST
Second Line	:	SUITE 202
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-6890
Country	:	US
Telephone Number	:	318-442-7303
Fax Number	:	318-442-7094

Authorized Official
Title or Position	:	AUDIOLOGIST / PRESIDENT
Name	:	MR. EDWARD CHARLES WILLS
Credential	:	M.A., CCC-A, FAAA
Telephone Number	:	318-442-7303

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	06/06/2008

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