Healthcare Provider Details

I. General information

NPI: 1962794131
Provider Name (Legal Business Name): EXELA HEARING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N WEBER ST STE 360
COLORADO SPRINGS CO
80907-7532
US

IV. Provider business mailing address

8076 W SAHARA AVE
LAS VEGAS NV
89117-7930
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-4000
  • Fax:
Mailing address:
  • Phone: 877-881-0022
  • Fax: 702-543-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
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: ERICA PERREIRA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 877-881-0022