Provider Demographics
NPI:1083225601
Name:WASHINGTON HEARING CENTER, LLC
Entity Type:Organization
Organization Name:WASHINGTON HEARING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:636-390-6020
Mailing Address - Street 1:1713 MADISON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4914
Mailing Address - Country:US
Mailing Address - Phone:636-390-6020
Mailing Address - Fax:636-390-6021
Practice Address - Street 1:1713 MADISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4914
Practice Address - Country:US
Practice Address - Phone:636-390-6020
Practice Address - Fax:636-390-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment