Provider Demographics
NPI:1558525717
Name:MEMPHIS HEARING AID & AUDIOLOGICAL SERVICES
Entity Type:Organization
Organization Name:MEMPHIS HEARING AID & AUDIOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENTON
Authorized Official - Middle Name:W
Authorized Official - Last Name:COX
Authorized Official - Suffix:III
Authorized Official - Credentials:AUD
Authorized Official - Phone:901-682-1529
Mailing Address - Street 1:7675 WOLF RIVER CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1748
Mailing Address - Country:US
Mailing Address - Phone:901-682-1529
Mailing Address - Fax:901-761-0592
Practice Address - Street 1:7675 WOLF RIVER CIR STE 101
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1748
Practice Address - Country:US
Practice Address - Phone:901-682-1529
Practice Address - Fax:901-761-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA120231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty