Provider Demographics
NPI:1841316791
Name:NEWBORN HEARING SERVICES-MB, INC
Entity type:Organization
Organization Name:NEWBORN HEARING SERVICES-MB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:314-251-4847
Mailing Address - Street 1:9888 OLD WARSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1068
Mailing Address - Country:US
Mailing Address - Phone:314-251-4847
Mailing Address - Fax:
Practice Address - Street 1:MISSOURI BAPTIST MEDICAL CENTER
Practice Address - Street 2:3015 N. BALLAS RD
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131
Practice Address - Country:US
Practice Address - Phone:314-251-4847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty