Provider Demographics
NPI:1184776759
Name:AUDIOLOGY & HEARING CENTERS OF NEPA, LLC
Entity type:Organization
Organization Name:AUDIOLOGY & HEARING CENTERS OF NEPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRISLUPSKI
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:570-343-7710
Mailing Address - Street 1:321 SPRUCE ST
Mailing Address - Street 2:BANK TOWER - 7TH FLOOR
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1400
Mailing Address - Country:US
Mailing Address - Phone:570-343-7710
Mailing Address - Fax:570-343-7734
Practice Address - Street 1:321 SPRUCE ST
Practice Address - Street 2:BANK TOWER - 7TH FLOOR
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1400
Practice Address - Country:US
Practice Address - Phone:570-343-7710
Practice Address - Fax:570-343-7734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000012L332S00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102958262-0001Medicaid
PA1007510830004Medicaid
PA0019075890003Medicaid
PA30132OtherGEISINGER
PA30132OtherGEISINGER