MEDICARE: AIM HEARING AND AUDIOLOGY SERVICE, 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	231HA2400X	Assistive Technology Practitioner Audiologist
2	231HA2500X	Assistive Technology Supplier Audiologist
3	237600000X	Audiologist-Hearing Aid Fitter	1215	NC
4	231H00000X	Audiologist	7151	NC

General Provider Information

NPI Number	:	1306162193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIM HEARING AND AUDIOLOGY SERVICE, PC

Provider Business Mailing Address
First Line	:	529 COLLEGE RD STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5164
Country	:	US
Telephone Number	:	336-294-9617
Fax Number	:	336-294-9419

Provider Business Practice Location Address
First Line	:	529 COLLEGE RD STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5164
Country	:	US
Telephone Number	:	336-294-9617
Fax Number	:	336-294-9419

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EMIL J FRYMARK
Credential	:	AU.D. CCC
Telephone Number	:	336-294-9617

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	07/10/2010

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