Provider Demographics
NPI:1922458470
Name:RJ AUDIOLOGY LTD
Entity Type:Organization
Organization Name:RJ AUDIOLOGY LTD
Other - Org Name:ASCENT AUDIOLOGY AND HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:508-996-0389
Mailing Address - Street 1:341 STATE RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-4319
Mailing Address - Country:US
Mailing Address - Phone:508-996-0389
Mailing Address - Fax:508-997-0429
Practice Address - Street 1:1122 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:MA
Practice Address - Zip Code:02726-2840
Practice Address - Country:US
Practice Address - Phone:508-675-4810
Practice Address - Fax:508-997-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA566332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110062832AMedicaid
MAS400168086Medicare UPIN