1699059543 NPI number — ACCUQUEST HEARING CENTER, INC.

Table of content: (NPI 1699059543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699059543 NPI number — ACCUQUEST HEARING CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCUQUEST 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:
ACCURATE HEARCARE CORPORATION
Provider Other Organization Name Type Code:
4
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:
1699059543
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 W HIGGINS RD
Provider Second Line Business Mailing Address:
STE 895
Provider Business Mailing Address City Name:
HOFFMAN ESTATES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60169-2071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-843-1900
Provider Business Mailing Address Fax Number:
847-843-1901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3252 HOLIDAY CT
Provider Second Line Business Practice Location Address:
STE 208
Provider Business Practice Location Address City Name:
LA JOLLA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92037-0027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-638-7808
Provider Business Practice Location Address Fax Number:
858-638-7865
Provider Enumeration Date:
10/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
TEMPLE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
847-843-1900

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  AU2110 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AU0021100 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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