Provider Demographics
NPI:1275547655
Name:ALEXANDRIA AUDIOLOGY SERVICES & DISCOUNT HEARING AIDS, INC.
Entity Type:Organization
Organization Name:ALEXANDRIA AUDIOLOGY SERVICES & DISCOUNT HEARING AIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A, FAAA
Authorized Official - Phone:318-442-7303
Mailing Address - Street 1:1605 MURRAY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6890
Mailing Address - Country:US
Mailing Address - Phone:318-442-7303
Mailing Address - Fax:318-442-7094
Practice Address - Street 1:1605 MURRAY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6890
Practice Address - Country:US
Practice Address - Phone:318-442-7303
Practice Address - Fax:318-442-7094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA709237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1415821OtherKID MED
LA1383805Medicaid
LA1967866Medicaid
LA1967866Medicaid