# PRINCETON AUDIOLOGY CLINIC, INC.,

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRINCETON AUDIOLOGY CLINIC, INC., DBA BLUE RIDGE HEARING
- **Other names:** dba Blue Ridge Hearing and Balance Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598981524
- **Legal business name:** PRINCETON AUDIOLOGY CLINIC, INC., DBA BLUE RIDGE HEARING
- **Authorized official:** ALAN L. DESMOND AU.D., CCC-A (PRESIDENT)
- **Authorized official phone:** (304) 487-2487

## Contact information

- **Practice address:** 2001 STADIUM DRIVE, SUITE D, BLUEFIELD, WV 24701
- **Practice address phone:** (304) 324-2954
- **Practice address fax:** (304) 324-2955
- **Mailing address:** 508 NEW HOPE ROAD, SUITE \#19, PRINCETON, WV 24740-2272
- **Mailing address phone:** (304) 487-2487
- **Mailing address fax:** (304) 431-3367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | NULL | Yes |
| 231H00000X | Audiologist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 332S00000X | Hearing Aid Equipment | — | NULL | — |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 09/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3810002482 | — | WV |
| 01 | — | CC375 | PALMETTO GBA RR MEDICARE | — |
| 01 | — | PR9319052 | MEDICARE PALMETTO GBA PTAN NUMBER | — |