Provider Demographics
NPI:1275602427
Name:ANDERSON ENTERPRISES, INC.
Entity Type:Organization
Organization Name:ANDERSON ENTERPRISES, INC.
Other - Org Name:WEST VIRGINIA HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCHIS
Authorized Official - Phone:304-369-1123
Mailing Address - Street 1:167 STATE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WV
Mailing Address - Zip Code:25130-1139
Mailing Address - Country:US
Mailing Address - Phone:304-369-1123
Mailing Address - Fax:304-369-9001
Practice Address - Street 1:167 STATE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WV
Practice Address - Zip Code:25130-1139
Practice Address - Country:US
Practice Address - Phone:304-369-1123
Practice Address - Fax:304-369-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV908237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty