MEDICARE: ATLANTA AUDIOLOGY, LLC

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

General Provider Information

NPI Number	:	1487346854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA AUDIOLOGY, LLC

Provider Business Mailing Address
First Line	:	220 SANDY SPRINGS CIR STE 185
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3861
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 SANDY SPRINGS CIR STE 185
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3861
Country	:	US
Telephone Number	:	404-919-7219
Fax Number	:

Authorized Official
Title or Position	:	OWNER / AUDIOLOGIST
Name	:	MERYL MILLER
Credential	:	AUD
Telephone Number	:	404-919-7219

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	05/24/2023

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