MEDICARE: HEAR ON EARTH HEARING CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332S00000X	Hearing Aid Equipment	290	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013179209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAR ON EARTH HEARING CARE CENTER

Provider Business Mailing Address
First Line	:	920 N TELSHOR BLVD
Second Line	:	STE A
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8244
Country	:	US
Telephone Number	:	575-523-8816
Fax Number	:	575-522-0026

Provider Business Practice Location Address
First Line	:	920 N TELSHOR BLVD
Second Line	:	STE A
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8244
Country	:	US
Telephone Number	:	575-523-8816
Fax Number	:	575-522-0026

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RAYMOND E BAMBERG
Credential	:	BC-HIS
Telephone Number	:	575-523-8816

Provider Enumeration Date	:	06/28/2008
Last Update Date	:	06/28/2008

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