Provider Demographics
NPI:1073707022
Name:MENENDEZ AUDIOLOGY LLC
Entity Type:Organization
Organization Name:MENENDEZ AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE/BILLING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:V
Authorized Official - Last Name:MCGRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-723-1592
Mailing Address - Street 1:426 8TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLEN DALE
Mailing Address - State:WV
Mailing Address - Zip Code:26038-1451
Mailing Address - Country:US
Mailing Address - Phone:866-921-3277
Mailing Address - Fax:304-723-1594
Practice Address - Street 1:499 COLLIERS WAY
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5011
Practice Address - Country:US
Practice Address - Phone:866-921-3277
Practice Address - Fax:304-723-1594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA90246231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty