1306514930 NPI number — MY HEARING CENTERS, LLC

Table of content: (NPI 1306514930)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306514930 NPI number — MY HEARING CENTERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MY 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:
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:
1306514930
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8941 S 700 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANDY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84070-2400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-316-9144
Provider Business Mailing Address Fax Number:
801-396-7066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
512 YELM AVE W UNIT A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YELM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98597-8773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-339-8026
Provider Business Practice Location Address Fax Number:
801-396-7066
Provider Enumeration Date:
08/30/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAMPP
Authorized Official First Name:
EILEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF INSURANCE
Authorized Official Telephone Number:
732-688-6486

Provider Taxonomy Codes

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

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