Provider Demographics
NPI:1053402750
Name:ASSOCIATED HEARINGS & DIAGNOSTICS
Entity type:Organization
Organization Name:ASSOCIATED HEARINGS & DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:VARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-964-7465
Mailing Address - Street 1:6719 GOVERNOR GC PEERY HWY STE 2500
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2489
Mailing Address - Country:US
Mailing Address - Phone:276-964-7465
Mailing Address - Fax:276-963-3507
Practice Address - Street 1:6719 GOVERNOR GC PEERY HWY STE 2500
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2489
Practice Address - Country:US
Practice Address - Phone:276-964-7465
Practice Address - Fax:276-963-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001303231H00000X
VA2102002260237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05399OtherMEDICARE PTAN
VA009100008OtherVIRGINIA MEDICAID
WV3810005010Medicaid
VA009100008OtherVIRGINIA MEDICAID