1912939307 NPI number — KNAPP HEARING AID CENTER LLP

Table of content: (NPI 1912939307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912939307 NPI number — KNAPP HEARING AID CENTER LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNAPP HEARING AID CENTER LLP
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 AMPLIFON HEARING AID CENTERS
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:
1912939307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 JOHNSON AVE
Provider Second Line Business Mailing Address:
SUITE 4N
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-842-3050
Provider Business Mailing Address Fax Number:
304-842-5733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 JOHNSON AVE
Provider Second Line Business Practice Location Address:
SUITE 4N
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-842-3050
Provider Business Practice Location Address Fax Number:
304-842-5733
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KNAPP
Authorized Official First Name:
CARLA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
304-842-3050

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  791 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332S00000X , with the licence number: 791 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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