Provider Demographics
NPI:1992834709
Name:ARCHES AUDIOLOGY LLC
Entity Type:Organization
Organization Name:ARCHES AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:435-259-2508
Mailing Address - Street 1:16 S 100 E
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-2638
Mailing Address - Country:US
Mailing Address - Phone:435-259-2508
Mailing Address - Fax:435-259-2513
Practice Address - Street 1:16 S 100 E
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-2638
Practice Address - Country:US
Practice Address - Phone:435-259-2508
Practice Address - Fax:435-259-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT61008144101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid
UT00058195Medicare PIN