MEDICARE: MIRACLE EAR

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		TN

General Provider Information

NPI Number	:	1215185509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRACLE EAR

Provider Business Mailing Address
First Line	:	2100 HAMILTON PL
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-6006
Country	:	US
Telephone Number	:	423-892-8510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 HAMILTON PL
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-6006
Country	:	US
Telephone Number	:	423-892-8510
Fax Number	:

Authorized Official
Title or Position	:	HEARING SPECIALIST
Name	:	MR. FRED BERGANINI
Credential	:
Telephone Number	:	423-892-8510

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	07/21/2022

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