Healthcare Provider Details

I. General information

NPI: 1053863704
Provider Name (Legal Business Name): HI-TECH HEARING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 GREGORY STREET
BLACK HAWK CO
80422
US

IV. Provider business mailing address

PO BOX 202
BLACK HAWK CO
80422-0202
US

V. Phone/Fax

Practice location:
  • Phone: 888-314-3739
  • Fax: 307-215-7474
Mailing address:
  • Phone: 888-314-3739
  • Fax: 307-215-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD0000300
License Number StateCO

VIII. Authorized Official

Name: MR. FRED ANDREW LAWRENCE
Title or Position: PRESIDENT
Credential: AAS, HIS
Phone: 888-314-3739