Provider Demographics
NPI:1295088482
Name:OCONEE AUDIOLOGY INC
Entity type:Organization
Organization Name:OCONEE AUDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-888-8865
Mailing Address - Street 1:10239 CLEMSON BLVD
Mailing Address - Street 2:ST 170
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-0861
Mailing Address - Country:US
Mailing Address - Phone:864-888-8865
Mailing Address - Fax:864-888-3838
Practice Address - Street 1:10239 CLEMSON BLVD
Practice Address - Street 2:ST 170
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-0861
Practice Address - Country:US
Practice Address - Phone:864-888-8865
Practice Address - Fax:864-888-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC465231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ332350281Medicare PIN