MEDICARE: ASH AUDIOLOGY PLLC

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	231H00000X	Audiologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750980009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASH AUDIOLOGY PLLC

Provider Business Mailing Address
First Line	:	2637 NW 26TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73107-2231
Country	:	US
Telephone Number	:	815-618-8006
Fax Number	:

Provider Business Practice Location Address
First Line	:	2637 NW 26TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73107-2231
Country	:	US
Telephone Number	:	815-618-8006
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUDIOLOGIST
Name	:	DR. RACHEL ASHLEY MAGANN FAIVRE
Credential	:	AU.D.
Telephone Number	:	815-618-8006

Provider Enumeration Date	:	10/19/2020
Last Update Date	:	10/19/2020

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