Healthcare Provider Details

I. General information

NPI: 1669548814
Provider Name (Legal Business Name): ALICE ANN THOMAS HEARING AID DISPENSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN A THOMAS HEARING AID DISPENSE

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43797 15TH ST W
LANCASTER CA
93534-4755
US

IV. Provider business mailing address

43797 15TH ST W
LANCASTER CA
93534-4755
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-4776
  • Fax: 661-948-8163
Mailing address:
  • Phone: 661-948-4776
  • Fax: 661-948-8163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA2445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: