Provider Demographics
NPI:1932144425
Name:AUDICARE HEARING CENTERS INC.
Entity Type:Organization
Organization Name:AUDICARE HEARING CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:231-238-3111
Mailing Address - Street 1:4620 US 31 N
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3757
Mailing Address - Country:US
Mailing Address - Phone:231-238-3111
Mailing Address - Fax:231-238-3218
Practice Address - Street 1:4620 US 31 N
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3757
Practice Address - Country:US
Practice Address - Phone:231-238-3111
Practice Address - Fax:231-238-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI640B827240OtherBLUE CROSS BLUE SHIELD
MI804707456Medicaid
MI902575198Medicaid
MI804707447Medicaid
MI904073810Medicaid
MI903380558Medicaid
MA540B802900OtherBLUE CROSS BLUE SHIELD
MI804707465Medicaid
MI0P36390Medicare PIN