Provider Demographics
NPI:1891857819
Name:INDUSTRIAL HEARING CONSERVATION ASSOCIATION
Entity Type:Organization
Organization Name:INDUSTRIAL HEARING CONSERVATION ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-636-5146
Mailing Address - Street 1:2500 FAIRMONT AVE
Mailing Address - Street 2:SUITE 709
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-3451
Mailing Address - Country:US
Mailing Address - Phone:304-636-5146
Mailing Address - Fax:
Practice Address - Street 1:2500 FAIRMONT AVE
Practice Address - Street 2:SUITE 709
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-3451
Practice Address - Country:US
Practice Address - Phone:304-636-5146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV024893174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN9328921Medicare ID - Type Unspecified