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NPI Code Detail

MEDICARE: CENTERVILLE HEARING CENTER, LLC

MEDICARE: CENTERVILLE HEARING CENTER, 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
1261QH0700XHearing and Speech Clinic/Center03304OH

General Provider Information

NPI Number : 1558805614
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTERVILLE HEARING CENTER, LLC
Provider Business Mailing Address
First Line : 7081 CORPORATE WAY
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-4223
Country : US
Telephone Number : 937-476-7186
Fax Number :
Provider Business Practice Location Address
First Line : 7081 CORPORATE WAY
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-4223
Country : US
Telephone Number : 937-476-7186
Fax Number :
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : LINDSAY R ANDERSON
Credential :
Telephone Number : 937-545-9740
Provider Enumeration Date : 12/08/2016
Last Update Date : 12/08/2016

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Directions to “CENTERVILLE HEARING CENTER, LLC ” Practice Location

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