1972718500 NPI number — QUALITY HEARING INSTRUMENTS LLC

Table of content: (NPI 1972718500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972718500 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:
1972718500
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:
49 SMITHFIELD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-561-0080
Provider Business Practice Location Address Fax Number:
518-561-9830
Provider Enumeration Date:
05/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRASIER
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
HEARING INSTRUMENT SPECIALIST
Authorized Official Telephone Number:
518-561-0081

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  14000039158 , registered in the state of NY ; 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)