Provider Demographics
NPI:1790977338
Name:YEAGERTOWN HEARING CENTER, P.C.
Entity Type:Organization
Organization Name:YEAGERTOWN HEARING CENTER, P.C.
Other - Org Name:CENTRE HALL AUDIOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:O
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:717-248-7248
Mailing Address - Street 1:13161 FERGUSON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:YEAGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17099-0414
Mailing Address - Country:US
Mailing Address - Phone:717-248-7248
Mailing Address - Fax:717-248-7323
Practice Address - Street 1:13161 FERGUSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-0414
Practice Address - Country:US
Practice Address - Phone:717-248-7248
Practice Address - Fax:717-248-7323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-OOO772-L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31571OtherGEISINGER HEALTH PIN
PAYE291863Medicare PIN