Organization
MOUNTAINEAR AUDIOLOGY & HEARING AID CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE RICHAREDS AU.D. (OWNER)
(304) 842-8445
Entity
Organization
Contact information
Practice address
135 STATE ST, BRIDGEPORT, WV 26330-1375
(304) 842-8445
(304) 842-8446
Mailing address
135 STATE ST, BRIDGEPORT, WV 26330-1375
(304) 842-8445
(304) 842-8446
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
010453
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AUD201
HEALTH PLAN #
WV
Enumeration date
01/29/2007
Last updated
08/22/2020
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