Provider Demographics
NPI:1386983096
Name:FAMILY FIRST AUDIOLOGY SERVICES, LLC
Entity type:Organization
Organization Name:FAMILY FIRST AUDIOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARISSE
Authorized Official - Middle Name:DEMISHIA
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:330-468-0337
Mailing Address - Street 1:26118 BROADWAY AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-6529
Mailing Address - Country:US
Mailing Address - Phone:440-786-0261
Mailing Address - Fax:440-786-1693
Practice Address - Street 1:26118 BROADWAY AVE
Practice Address - Street 2:UNIT C
Practice Address - City:OAKWOOD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44146-6529
Practice Address - Country:US
Practice Address - Phone:440-786-0261
Practice Address - Fax:440-786-1693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0110834Medicaid
OH1821185570Medicare NSC