Provider Demographics
NPI:1356682348
Name:CENTRAL AUDIOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:CENTRAL AUDIOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-739-0400
Mailing Address - Street 1:1800 DUAL HWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6602
Mailing Address - Country:US
Mailing Address - Phone:301-739-0400
Mailing Address - Fax:301-739-0402
Practice Address - Street 1:1800 DUAL HWY
Practice Address - Street 2:SUITE 301
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6602
Practice Address - Country:US
Practice Address - Phone:301-739-0400
Practice Address - Fax:301-739-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty