Provider Demographics
NPI:1497950919
Name:AUGUSTA AUDIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:AUGUSTA AUDIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRAR-HERSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-332-5790
Mailing Address - Street 1:70 MEDICAL CENTER CIRCLE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2273
Mailing Address - Country:US
Mailing Address - Phone:540-332-5790
Mailing Address - Fax:540-332-5792
Practice Address - Street 1:70 MEDICAL CENTER CIRCLE
Practice Address - Street 2:SUITE 204
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-332-5790
Practice Address - Fax:540-332-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03988Medicare PIN