Provider Demographics
NPI:1285785436
Name:AUDIOLOGY ASSOCIATES, INC.
Entity type:Organization
Organization Name:AUDIOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSNESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLLERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-224-8848
Mailing Address - Street 1:633 E SIOUX AVE
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-3368
Mailing Address - Country:US
Mailing Address - Phone:605-224-8848
Mailing Address - Fax:605-224-7078
Practice Address - Street 1:633 E SIOUX AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3368
Practice Address - Country:US
Practice Address - Phone:605-224-8848
Practice Address - Fax:605-224-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD33-001-E-UT231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5830132Medicaid
SD5830592Medicaid
SD5830592Medicaid
SD68002Medicare ID - Type UnspecifiedSD AUDIOLOGY MEDICARE NUM
SD2791Medicare ID - Type UnspecifiedAUDIOLOGY OFFICE NUMBER