Provider Demographics
NPI:1023283116
Name:ALLEGANY HEARING AND BALANCE LLC
Entity type:Organization
Organization Name:ALLEGANY HEARING AND BALANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:301-729-1635
Mailing Address - Street 1:938 NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7326
Mailing Address - Country:US
Mailing Address - Phone:301-729-1635
Mailing Address - Fax:
Practice Address - Street 1:6500 THAYER CTR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1116
Practice Address - Country:US
Practice Address - Phone:301-334-1018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00586231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403430901Medicaid
MDJ813OtherGHMSI & BLUECHOICE
MD425337OtherMAMSI
MD1017225OtherWV WORKERS' COMPENSATION
MDDC 1503OtherRAILROAD MEDICARE
MD2556420OtherUNITED HEALTHCARE
MD855AOtherCAREFIST BCBS OF MD
MD403430900Medicaid
MD874MOtherMEDICARE