1003985938 NPI number — HEARING IMPROVEMENT CENTER LLC

Table of content: (NPI 1003985938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003985938 NPI number — HEARING IMPROVEMENT CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEARING IMPROVEMENT CENTER 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:
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:
1003985938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28 NORTH MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06107-1971
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-561-2345
Provider Business Mailing Address Fax Number:
860-561-2666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28 NORTH MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06107-1971
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-561-2345
Provider Business Practice Location Address Fax Number:
860-561-2666
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUMAINE
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
MEMBER LLC
Authorized Official Telephone Number:
860-529-3443

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 5813236 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 730000154CT02 . This is a "ANTHEM BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P365924 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P848736 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4499372 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: XV5339 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 730000154CT01 . This is a "ANTHEM BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2211721 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: OV5339 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: OV5578 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004173564 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com