1639386709 NPI number — QUALITY HEARING INSTRUMENTS 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 1639386709 NPI number — QUALITY HEARING INSTRUMENTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY HEARING INSTRUMENTS 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:
MIRACLE EAR
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:
1639386709
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
131 ENTERPRISE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12095-3326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-353-4174
Provider Business Mailing Address Fax Number:
401-488-5774

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
935 RIVERDALE ST
Provider Second Line Business Practice Location Address:
UNIT 6
Provider Business Practice Location Address City Name:
WEST SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01089-4656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-205-2911
Provider Business Practice Location Address Fax Number:
413-205-2997
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FRASIER
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
HEARING INSTUMENT SPECIALIST
Authorized Official Telephone Number:
413-205-2911

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  299 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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