1831350560 NPI number — JADE HEARING INSTRUMENTS LLP

Table of content: (NPI 1831350560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831350560 NPI number — JADE HEARING INSTRUMENTS LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JADE HEARING INSTRUMENTS LLP
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:
1831350560
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5629 SASHABAW RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKSTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-922-5600
Provider Business Mailing Address Fax Number:
248-922-1046

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5629 SASHABAW RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-922-5600
Provider Business Practice Location Address Fax Number:
248-922-1046
Provider Enumeration Date:
06/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHELL
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
LISENSED HEARING AID DEALER BUISNES
Authorized Official Telephone Number:
248-922-5600

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  3501001649 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 540F329960 . This is a "BCBS PIN" identifier . This identifiers is of the category "OTHER".