Provider Demographics
NPI: | 1346875390 |
---|---|
Name: | APEX PROFESSIONAL AUDIOLOGY, LLC |
Entity Type: | Organization |
Organization Name: | APEX PROFESSIONAL AUDIOLOGY, LLC |
Other - Org Name: | AUDIOLOGY HEARS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER, AUDIOLOGIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHONDA |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | BAILEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | AUD |
Authorized Official - Phone: | 770-781-2376 |
Mailing Address - Street 1: | 6130 SOUTHARD TRCE |
Mailing Address - Street 2: | |
Mailing Address - City: | CUMMING |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30040-6475 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 770-781-2376 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6130 SOUTHARD TRCE |
Practice Address - Street 2: | |
Practice Address - City: | CUMMING |
Practice Address - State: | GA |
Practice Address - Zip Code: | 30040-6475 |
Practice Address - Country: | US |
Practice Address - Phone: | 770-781-2376 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-03-10 |
Last Update Date: | 2020-03-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | Group - Single Specialty |