Healthcare Provider Details

I. General information

NPI: 1104964428
Provider Name (Legal Business Name): INNOVATIVE HEARING SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25521 E SMOKY HILL RD STE 220
AURORA CO
80016
US

IV. Provider business mailing address

PO BOX 25208
COLORADO SPRINGS CO
80936
US

V. Phone/Fax

Practice location:
  • Phone: 303-400-2988
  • Fax: 303-400-1227
Mailing address:
  • Phone: 303-400-2988
  • Fax: 303-400-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number144576
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number328
License Number StateCO

VIII. Authorized Official

Name: CAROL M SMITH
Title or Position: PRACTICE MANATER
Credential:
Phone: 303-400-2988