Provider Demographics
NPI:1073287694
Name:MEADOWCREST AUDIOLOGY
Entity Type:Organization
Organization Name:MEADOWCREST AUDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CULBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:301-351-8018
Mailing Address - Street 1:37 CLAYMONT DR
Mailing Address - Street 2:
Mailing Address - City:EARLYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22936-1641
Mailing Address - Country:US
Mailing Address - Phone:301-351-8018
Mailing Address - Fax:
Practice Address - Street 1:4765 SPOTSWOOD TRL
Practice Address - Street 2:
Practice Address - City:PENN LAIRD
Practice Address - State:VA
Practice Address - Zip Code:22846-2004
Practice Address - Country:US
Practice Address - Phone:301-351-8018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech