Provider Demographics
NPI:1447962972
Name:GOLD N SOURCING
Entity type:Organization
Organization Name:GOLD N SOURCING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARIE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:412-716-9273
Mailing Address - Street 1:326 PARK EDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:PA
Mailing Address - Zip Code:15026-1782
Mailing Address - Country:US
Mailing Address - Phone:412-716-9273
Mailing Address - Fax:
Practice Address - Street 1:326 PARK EDGE DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:PA
Practice Address - Zip Code:15026-1782
Practice Address - Country:US
Practice Address - Phone:412-716-9273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1184009060Medicaid