1699165639 NPI number — MITCHELL HEARING AIDE CENTER INC.

Table of content: (NPI 1699165639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699165639 NPI number — MITCHELL HEARING AIDE CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MITCHELL HEARING AIDE CENTER INC.
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:
6
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:
1699165639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1288 DAKOTA S.
Provider Second Line Business Mailing Address:
SUITE #1
Provider Business Mailing Address City Name:
HURON
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-332-1585
Provider Business Mailing Address Fax Number:
605-352-9046

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1288 DAKOTA S.
Provider Second Line Business Practice Location Address:
SUITE #1
Provider Business Practice Location Address City Name:
HURON
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-332-1585
Provider Business Practice Location Address Fax Number:
605-352-9046
Provider Enumeration Date:
01/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
WAHLE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
605-352-1585

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  288H , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com