1962673129 NPI number — ACCUQUEST HEARING CENTERS, LLC

Table of content: (NPI 1962673129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962673129 NPI number — ACCUQUEST HEARING CENTERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCUQUEST HEARING CENTERS, 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:
ACCURATE HEARCARE OF MINNESOTA
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:
1962673129
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 W HIGGINS ROAD
Provider Second Line Business Mailing Address:
SUITE 895
Provider Business Mailing Address City Name:
HOFFMAN ESTATES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60169
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:
1305 1ST STREET SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLMAR
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56201-4236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-214-7737
Provider Business Practice Location Address Fax Number:
320-235-0797
Provider Enumeration Date:
03/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CARLSON
Authorized Official First Name:
ASHLIE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CORP. INSURANCE MANAGER
Authorized Official Telephone Number:
847-843-1900

Provider Taxonomy Codes

  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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