Provider Demographics
NPI:1841662855
Name:KEYSTONE AUDIOLOGY, LLC
Entity type:Organization
Organization Name:KEYSTONE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:CONLEY
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:401-739-4327
Mailing Address - Street 1:400 BALD HILL RD STE 529
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-6111
Mailing Address - Country:US
Mailing Address - Phone:401-739-4327
Mailing Address - Fax:401-736-4327
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 529
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-595-7318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIS00061063332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment