1841844800 NPI number — NATIONAL HEARING AND BALANCE, LLC.

Table of content: (NPI 1841844800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841844800 NPI number — NATIONAL HEARING AND BALANCE, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL HEARING AND BALANCE, 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:
1841844800
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 15042
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIO RANCHO
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87174-0042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-207-7550
Provider Business Mailing Address Fax Number:
505-207-7559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6709 ACADEMY RD NE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-3363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-217-0912
Provider Business Practice Location Address Fax Number:
505-217-0913
Provider Enumeration Date:
07/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ROGERS
Authorized Official First Name:
BRAD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
505-715-3710

Provider Taxonomy Codes

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

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

  • Identifier: 889418 . This is a "GROUP MEDICARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 889418 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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