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NPI Code Detail

MEDICARE: SPEECHCENTER, INC.

MEDICARE: SPEECHCENTER, 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
1235Z00000XSpeech-Language PathologistNC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20272COTHERNCBLUE CROSS BLUE SHIELD NC

General Provider Information

NPI Number : 1306840251
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEECHCENTER, INC.
Provider Business Mailing Address
First Line : 185 CHARLOIS BLVD.
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27103-1521
Country : US
Telephone Number : 336-725-0222
Fax Number : 336-725-0454
Provider Business Practice Location Address
First Line : 185 CHARLOIS BLVD.
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27107-1521
Country : US
Telephone Number : 336-725-0222
Fax Number : 336-725-0454
Authorized Official
Title or Position : VICE PRESIDENT, COO
Name : MS. JERI L. BATES
Credential :
Telephone Number : 336-725-0222
Provider Enumeration Date : 06/09/2005
Last Update Date : 08/16/2012

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Directions to “SPEECHCENTER, INC. ” Practice Location

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