Provider Demographics
NPI:1326182189
Name:MODERNHEARINGAIDCENTERINC
Entity Type:Organization
Organization Name:MODERNHEARINGAIDCENTERINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-322-4272
Mailing Address - Street 1:1900 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2618
Mailing Address - Country:US
Mailing Address - Phone:205-322-4272
Mailing Address - Fax:205-323-3228
Practice Address - Street 1:1900 11TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2618
Practice Address - Country:US
Practice Address - Phone:205-322-4272
Practice Address - Fax:205-323-3228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4009237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7320427OtherAETNA
AL052090OtherBLUECROSSBLUESHIELD