Provider Demographics
NPI:1821098062
Name:AUDIOLOGY HEARING AID ASSOCIATES, INC.
Entity Type:Organization
Organization Name:AUDIOLOGY HEARING AID ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GNEWIKOW
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:434-799-6288
Mailing Address - Street 1:2104 LANGHORNE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1424
Mailing Address - Country:US
Mailing Address - Phone:434-528-4245
Mailing Address - Fax:434-528-3685
Practice Address - Street 1:2104 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1424
Practice Address - Country:US
Practice Address - Phone:434-528-4245
Practice Address - Fax:434-528-3685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5775231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
149510300OtherDEPARTMENT OF LABOR
5401361858OtherPRIMARY PHYSICIAN CARE
VA5775OtherBUSINESS LICENSE
27602OtherSOUTHERN HEALTH SERVICES
18786OtherOPTIMA FAMILY
VA57750OtherANTHEM OF VIRGINIA