Provider Demographics
NPI:1891926994
Name:HEARING CENTER OF CHESTERTOWN, LLC
Entity Type:Organization
Organization Name:HEARING CENTER OF CHESTERTOWN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:410-778-5170
Mailing Address - Street 1:818 HIGH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1152
Mailing Address - Country:US
Mailing Address - Phone:410-778-5170
Mailing Address - Fax:410-778-6195
Practice Address - Street 1:818 HIGH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1152
Practice Address - Country:US
Practice Address - Phone:410-778-5170
Practice Address - Fax:410-778-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00620237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3409241OtherAETNA
MD1M67BAOtherBC/BS OF MARYLAND
MDJ395OtherFEDERAL BC/BS
G2OtherCOVENTRY
2130571OtherUNITED HEALTHCARE
MDJ395OtherFEDERAL BC/BS