Provider Demographics
NPI:1528200359
Name:AVADA AUDIOLOGY & HEARING CARE
Entity Type:Organization
Organization Name:AVADA AUDIOLOGY & HEARING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL AUDIIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDREN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:252-940-0068
Mailing Address - Street 1:1604 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3364
Mailing Address - Country:US
Mailing Address - Phone:252-940-0068
Mailing Address - Fax:252-940-0068
Practice Address - Street 1:1604 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3364
Practice Address - Country:US
Practice Address - Phone:252-940-0068
Practice Address - Fax:252-940-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1172332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies