Provider Demographics
NPI:1508293572
Name:CAVENEE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:CAVENEE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AU.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:CAVENEE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:620-755-2009
Mailing Address - Street 1:P.O. BOX 670
Mailing Address - Street 2:
Mailing Address - City:TRIBUNE
Mailing Address - State:KS
Mailing Address - Zip Code:67879
Mailing Address - Country:US
Mailing Address - Phone:620-755-2009
Mailing Address - Fax:
Practice Address - Street 1:109 WEST GREELEY
Practice Address - Street 2:
Practice Address - City:TRIBUNE
Practice Address - State:KS
Practice Address - Zip Code:67879
Practice Address - Country:US
Practice Address - Phone:620-755-2009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2245231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty