MEDICARE: HEARTLAND HEARING 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	237600000X	Audiologist-Hearing Aid Fitter	21783	NE

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	:	1558443002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND HEARING CENTER

Provider Business Mailing Address
First Line	:	7710 MERCY RD
Second Line	:	BERGAN PROFESSIONAL CENTER NORTH, SUITE 322
City	:	OMAHA
State	:	NE
Zip	:	68124-2372
Country	:	US
Telephone Number	:	402-932-1999
Fax Number	:	402-932-1948

Provider Business Practice Location Address
First Line	:	7710 MERCY RD
Second Line	:	BERGAN PROFESSIONAL CENTER NORTH, SUITE 322
City	:	OMAHA
State	:	NE
Zip	:	68124-2372
Country	:	US
Telephone Number	:	402-932-1999
Fax Number	:	402-932-1948

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK DOUGLAS FREY
Credential	:	M.D.
Telephone Number	:	402-932-1999

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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Directions to “HEARTLAND HEARING CENTER ” Practice Location

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