Provider Demographics
NPI:1629149455
Name:ADVANCED PROFESSIONAL HEARING AID SERVICES INC.
Entity Type:Organization
Organization Name:ADVANCED PROFESSIONAL HEARING AID SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-760-8804
Mailing Address - Street 1:318 LEE STREET WEST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302
Mailing Address - Country:US
Mailing Address - Phone:304-345-7102
Mailing Address - Fax:304-345-7101
Practice Address - Street 1:318 LEE STREET WEST
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302
Practice Address - Country:US
Practice Address - Phone:304-345-7102
Practice Address - Fax:304-345-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001705055OtherMOUNTAIN STATE BLUE CROSS
WV3810010075Medicaid
WVAD9345541Medicare PIN