Healthcare Provider Details

I. General information

NPI: 1104011964
Provider Name (Legal Business Name): CLEARLYUSA.COM, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N SECTION ST
FAIRHOPE AL
36532-2649
US

IV. Provider business mailing address

411 N SECTION ST
FAIRHOPE AL
36532-2649
US

V. Phone/Fax

Practice location:
  • Phone: 251-517-5060
  • Fax: 251-517-5062
Mailing address:
  • Phone: 251-517-5060
  • Fax: 251-517-5062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD B. BAKER
Title or Position: MANAGING MEMBER
Credential:
Phone: 251-517-5060