Dba Blue Ridge Hearing And Balance Clinic is a medicare enrolled "Hearing Aid Equipment" provider in Princeton, West Virginia. Their current practice location is
508 New Hope Road, Suite #19, Princeton, West Virginia. You can reach out to their office (for appointments etc.) via phone at
(304) 487-2487.
Dba Blue Ridge Hearing And Balance Clinic is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Dba Blue Ridge Hearing And Balance Clinic
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1073580817.
Healthcare Provider's Profile
| Full Name | Dba Blue Ridge Hearing And Balance Clinic |
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| Type | Facility |
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| Speciality | Hearing Aid Equipment |
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| Location | 508 New Hope Road, Princeton, West Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1073580817
- Provider Enumeration Date: 03/01/2006
- Last Update Date: 06/05/2013
Medicare PECOS Information:
- PECOS PAC ID: 1052300357
- Enrollment ID: O20040511001102
Medical Identifiers
Medical identifiers for Dba Blue Ridge Hearing And Balance Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073580817 | NPI | - | NPPES |
| CC3775 | Other | | PALMETTO GBA RR MEDICARE |
| 4250000-000 | Medicaid | WV | |
| 4250000000 | Medicaid | WV | |
| PR9319052 | Other | | PALMETTO GBA MEDICARE PTAN NUMBER BLFD OFFICE |
| 3810002482 | Medicaid | WV | |
| PR9319051 | Other | | PALMETTO GBA MEDICARE PTAN NUMBER PCTN OFFICE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 231H00000X | Audiologist | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 332S00000X | Hearing Aid Equipment | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Dba Blue Ridge Hearing And Balance Clinic acts as a billing entity for following providers:
| Provider Name | Sharon Lynne Jividen |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1609843440
PECOS PAC ID: 1355394941
Enrollment ID: I20050223000524 |
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| Provider Name | Alan L Desmond |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1275501439
PECOS PAC ID: 6709875917
Enrollment ID: I20101110000671 |
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| Provider Name | Tara J Minnix-harmon |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1962799338
PECOS PAC ID: 4183896897
Enrollment ID: I20110930000180 |
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| Provider Name | Lindsey S Underwood |
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| Provider Type | Practitioner - Qualified Audiologist |
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| Provider Identifiers | NPI Number: 1831502384
PECOS PAC ID: 8224255435
Enrollment ID: I20140812002082 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dba Blue Ridge Hearing And Balance Clinic is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dba Blue Ridge Hearing And Balance Clinic
508 New Hope Road, Suite #19,
Princeton, WV 24740-2272
Ph: (304) 487-2487 | Dba Blue Ridge Hearing And Balance Clinic
508 New Hope Road, Suite #19,
Princeton, WV 24740-2272
Ph: (304) 487-2487 |
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