Provider Demographics
NPI:1245303411
Name:AUDIOLOGIC HEARING SERVICES INC
Entity type:Organization
Organization Name:AUDIOLOGIC HEARING SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:508-829-7048
Mailing Address - Street 1:52 BOYDEN ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520
Mailing Address - Country:US
Mailing Address - Phone:508-829-7048
Mailing Address - Fax:508-829-1702
Practice Address - Street 1:52 BOYDEN ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:508-829-7048
Practice Address - Fax:508-829-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9750291Medicaid
MAAD0143OtherBLUE CROSS
MA693492OtherTUFTS
MAAD0143OtherBLUE CROSS
MA9750291Medicaid