Provider Demographics
NPI:1013027242
Name:D&A DISSOLVING, INC.
Entity Type:Organization
Organization Name:D&A DISSOLVING, INC.
Other - Org Name:DARR & ASSOCIATES, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:RAE DEANE
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:269-271-5208
Mailing Address - Street 1:319 W CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49032-9657
Mailing Address - Country:US
Mailing Address - Phone:269-271-5207
Mailing Address - Fax:574-289-4327
Practice Address - Street 1:218 S FRANCES ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-3004
Practice Address - Country:US
Practice Address - Phone:574-232-5815
Practice Address - Fax:574-289-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002137A237600000X
MI3501002824237600000X
IN23002216A237600000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100280770AMedicaid
MI540A402560OtherBCBS MI HEARING AIDS
MI804742301Medicaid
MI640A426010OtherBCBS MI AUDIOLOGY
IN200122530AMedicaid
IN000000391214OtherANTHEM AUDIOLOGY/AIDS
IN000000247031OtherANTHEM AUDIOLOGY /AIDS
IN200469120AMedicaid
MI903366906Medicaid