Provider Demographics
NPI:1245451897
Name:RICHARD W. FOUST, INC.
Entity type:Organization
Organization Name:RICHARD W. FOUST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WANDS
Authorized Official - Last Name:FOUST
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:814-834-7721
Mailing Address - Street 1:111 BERGAMOT WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-8544
Mailing Address - Country:US
Mailing Address - Phone:814-353-4137
Mailing Address - Fax:814-353-4137
Practice Address - Street 1:20 N MICHAEL ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1394
Practice Address - Country:US
Practice Address - Phone:814-834-7721
Practice Address - Fax:814-834-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAAAAAAAAT000019L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017923550001Medicaid
PAR06664Medicare UPIN
PA207010U4MMedicare ID - Type Unspecified