Provider Demographics
NPI:1316107451
Name:MENDLIK AUDIOLOGY LLC
Entity type:Organization
Organization Name:MENDLIK AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:MENDLIK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:402-372-3864
Mailing Address - Street 1:129 E GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-1814
Mailing Address - Country:US
Mailing Address - Phone:402-372-3864
Mailing Address - Fax:402-727-8896
Practice Address - Street 1:129 E GRANT ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NE
Practice Address - Zip Code:68788-1814
Practice Address - Country:US
Practice Address - Phone:402-372-3864
Practice Address - Fax:402-727-8896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE127231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099713OtherMEDICARE GROUP
NE10025278000Medicaid
NE10025278100OtherMEDICAID HEAR AID
NE279050Medicare PIN