Provider Demographics
NPI:1043322407
Name:CLEAR CHOICE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:CLEAR CHOICE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:740-344-1304
Mailing Address - Street 1:36 MCMILLEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1809
Mailing Address - Country:US
Mailing Address - Phone:740-344-1304
Mailing Address - Fax:740-344-1305
Practice Address - Street 1:36 MCMILLEN DRIVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1809
Practice Address - Country:US
Practice Address - Phone:740-344-1304
Practice Address - Fax:740-344-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDL-006081332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2446697Medicaid
OH2446697Medicaid