MEDICARE: MARGARET LUMMUS HAS

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	237700000X	Hearing Instrument Specialist	AS5420	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11111	OTHER		NA

General Provider Information

NPI Number	:	1770043366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET LUMMUS HAS

Provider Business Mailing Address
First Line	:	122 EGLIN PKWY NE
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-4917
Country	:	US
Telephone Number	:	850-243-3196
Fax Number	:	850-270-5124

Provider Business Practice Location Address
First Line	:	122 EGLIN PKWY NE
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-4917
Country	:	US
Telephone Number	:	850-243-3196
Fax Number	:	850-270-5124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	03/21/2019

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