1477540755 NPI number — ALL EARS HEARING CENTER INC

Table of content: (NPI 1477540755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477540755 NPI number — ALL EARS HEARING CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL EARS HEARING CENTER INC
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:
Provider Other Organization Name Type Code:
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:
1477540755
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
59 INDUSTRIAL PARK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02360-4870
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-747-4055
Provider Business Mailing Address Fax Number:
508-747-7655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
59 INDUSTRIAL PARK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02360-4870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-747-4055
Provider Business Practice Location Address Fax Number:
508-747-7655
Provider Enumeration Date:
10/03/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CODY
Authorized Official First Name:
MARY
Authorized Official Middle Name:
MARGARET
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
508-747-4055

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  140 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AD0001 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 614363 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".