MEDICARE: CINCINNATI HEARING AND TINNITUS

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	332S00000X	Hearing Aid Equipment	A01360	OH

General Provider Information

NPI Number	:	1437495124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI HEARING AND TINNITUS

Provider Business Mailing Address
First Line	:	9723 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-7207
Country	:	US
Telephone Number	:	513-675-8595
Fax Number	:	513-793-9576

Provider Business Practice Location Address
First Line	:	9723 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-7207
Country	:	US
Telephone Number	:	513-675-8595
Fax Number	:	513-793-9576

Authorized Official
Title or Position	:	PRESIDENT/AUDIOLOGIST
Name	:	DR. MARLO BAILEY LAWRENCE
Credential	:	AUD
Telephone Number	:	513-675-8595

Provider Enumeration Date	:	12/27/2012
Last Update Date	:	03/31/2015

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