Healthcare Provider Details

I. General information

NPI: 1073582060
Provider Name (Legal Business Name): HEARING CARE RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 SW COLUMBIA AVE SUITE 101
LAKE CITY FL
32025-4301
US

IV. Provider business mailing address

132 SW COLUMBIA AVE SUITE 101
LAKE CITY FL
32025-4301
US

V. Phone/Fax

Practice location:
  • Phone: 386-754-6711
  • Fax: 386-754-6713
Mailing address:
  • Phone: 386-754-6711
  • Fax: 386-754-6713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number06-03205
License Number StateFL

VIII. Authorized Official

Name: MR. KENDALL P VARNEY
Title or Position: OWNER
Credential: M.S., AUD
Phone: 386-754-6711