Audiology & Hearing Center of Farmington, Inc

Organization Active NPI Audiologist-Hearing Aid Fitter · Farmington, MO

NPI 1124060561 · NPPES record last updated Aug 17, 2018

Key facts

NPI
1124060561
Entity type
Organization (NPI type 2)
Primary specialty
Audiologist-Hearing Aid Fitter 237600000X
License
113484 (MO)
Legal business name
AUDIOLOGY & HEARING CENTER OF FARMINGTON, INC
Practice address
620 Walton Dr
Farmington, MO 63640-1935
Phone
(573) 756-0500
Fax
(573) 756-0505
NPI assigned
Jun 11, 2006
Organization subpart
No

Authorized official

Name
Karen Renee Melton, AU.D.
Title
President
Phone
(573) 756-0500

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060808000006 MO Part B Supplier - Clinic/Group Practice 8921001298 Receives reassigned benefits from 2 practitioners
Practice locations: Farmington, MO; Herculaneum, MO

National Provider Directory

Tax ID family
Audiology Hearing Center (2 organizations share this tax ID)

Locations

560 Maple Valley Dr
Farmington, MO 63640
Phone (573) 756-0500

1185 Scenic Dr
Ste 157
Herculaneum, MO 63048
Phone (573) 756-0500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter
Group: 193400000X SINGLE SPECIALTY GROUP
237600000X 113484 MO Yes

Addresses

Primary practice location

620 Walton Dr
Farmington, MO 63640-1935

Mailing address

620 Walton Dr
Farmington, MO 63640-1935
Phone (573) 756-0500

Other identifiers

IdentifierTypeStateIssuer
45-00144OtherMOUHC
193973OtherMOBCBS
7035519OtherMOAETNA
338885437MedicaidMO
621859OtherMOHEALTHLINK

Other providers in Farmington, MO

All providers in Farmington, MO · Audiologist-Hearing Aid Fitter in Missouri

Sources for this page

Verify at the official NPI Registry.