1104999333 NPI number — MISSOURI HEARING ASSOCIATE LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104999333 NPI number — MISSOURI HEARING ASSOCIATE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MISSOURI HEARING ASSOCIATE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMPLIFON HEARING AID CENTERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104999333
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13600 S ALDEN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLATHE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66062-5829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-782-2546
Provider Business Mailing Address Fax Number:
913-782-4216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 N STATE ROUTE 291
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISONVILLE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64701-1218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-380-2664
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
O'GARA
Authorized Official First Name:
CHAD
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FRANCHISE OWNER
Authorized Official Telephone Number:
913-782-2546

Provider Taxonomy Codes

  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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