Provider Demographics
NPI:1679826101
Name:SOUTHERN VERMONT AUDIOLOGY, INC.
Entity Type:Organization
Organization Name:SOUTHERN VERMONT AUDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWKES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:802-366-8020
Mailing Address - Street 1:5420 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255-9481
Mailing Address - Country:US
Mailing Address - Phone:802-366-8020
Mailing Address - Fax:802-366-8030
Practice Address - Street 1:5420 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-9481
Practice Address - Country:US
Practice Address - Phone:802-366-8020
Practice Address - Fax:802-366-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1021217Medicaid
1578563490Medicare NSC