Provider Demographics
NPI:1134314305
Name:AUDIO-LOGIC, PC
Entity Type:Organization
Organization Name:AUDIO-LOGIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:402-564-9198
Mailing Address - Street 1:3763 39TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-4504
Mailing Address - Country:US
Mailing Address - Phone:402-564-9198
Mailing Address - Fax:402-564-9821
Practice Address - Street 1:3763 39TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4504
Practice Address - Country:US
Practice Address - Phone:402-564-9198
Practice Address - Fax:402-564-9821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE96237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NER29722Medicare UPIN
NE=========00Medicaid