Basic Information
Provider Information
NPI: 1003152950
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASH
FirstName: JOSEPH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BC-HIS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11900 US HIGHWAY 280
Address2:  
City: ELLABELL
State: GA
PostalCode: 313083603
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3450 WRIGHTSBORO RD STE B
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309092516
CountryCode: US
TelephoneNumber: 7067319943
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/21/2012
LastUpdateDate: 12/21/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000XHAS-0402SCN Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 
237700000XHADS000664GAY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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