Provider Demographics
NPI:1023558483
Name:KIM AUDIOLOGY & HEARING AID CENTER, LLC
Entity Type:Organization
Organization Name:KIM AUDIOLOGY & HEARING AID CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM LOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:267-982-7685
Mailing Address - Street 1:12 OLD CEDARBROOK RD
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2040
Mailing Address - Country:US
Mailing Address - Phone:267-982-7685
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD STE 215
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3724
Practice Address - Country:US
Practice Address - Phone:215-935-6990
Practice Address - Fax:215-935-6636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006416302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization