Basic Information
| Provider Information | |||||||||
| NPI: | 1962890855 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AUDIBEL OF NEPA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26222 RR 12 | ||||||||
| Address2: | |||||||||
| City: | DRIPPING SPRINGS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786204903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128580300 | ||||||||
| FaxNumber: | 5128582714 | ||||||||
| Practice Location | |||||||||
| Address1: | 1124 MEADE ST | ||||||||
| Address2: | |||||||||
| City: | DUNMORE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 185123169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703445311 | ||||||||
| FaxNumber: | 5703445518 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2014 | ||||||||
| LastUpdateDate: | 12/31/2014 | ||||||||
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| AuthorizedOfficialLastName: | SCHOEBORN | ||||||||
| AuthorizedOfficialFirstName: | RANDY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGEMENT PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 5125850300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NS HEARING NETWORK | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | Y | Suppliers | Hearing Aid Equipment |
No ID Information.