Healthcare Provider Details

I. General information

NPI: 1225250434
Provider Name (Legal Business Name): MEADVILLE HEARING AIDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 04/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 ROGERS AVE CENTRAL MALL SUITE 550
FORT SMITH AR
72903-2047
US

IV. Provider business mailing address

5111 ROGERS AVE CENTRAL MALL SUITE 550
FORT SMITH AR
72903-2047
US

V. Phone/Fax

Practice location:
  • Phone: 479-484-5485
  • Fax: 479-484-7051
Mailing address:
  • Phone: 479-484-5485
  • Fax: 479-484-7051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number16
License Number StateAR

VIII. Authorized Official

Name: MR. JONATHAN WENDELL HOWARD
Title or Position: PRESIDENT
Credential:
Phone: 479-484-5485