Provider Demographics
NPI:1326184938
Name:DE MCVEY ENTERPRISES INC
Entity Type:Organization
Organization Name:DE MCVEY ENTERPRISES INC
Other - Org Name:DILES HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GONCZY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:740-594-3571
Mailing Address - Street 1:275 WEST UNION STREET
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2313
Mailing Address - Country:US
Mailing Address - Phone:740-594-3571
Mailing Address - Fax:740-592-2212
Practice Address - Street 1:275 WEST UNION STREET
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2313
Practice Address - Country:US
Practice Address - Phone:740-594-3571
Practice Address - Fax:740-592-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00238231H00000X, 237600000X
OHA01741231H00000X
WVWV0269231H00000X
OHA01953231H00000X
OH01419237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00093715OtherRAILROAD MEDICARE
000000155161OtherANTHEM BCBS
OH0214842Medicaid
292506919001OtherMEDICAL MUTUAL
WV3810000989Medicaid
OH9267522Medicare PIN