Healthcare Provider Details

I. General information

NPI: 1750145934
Provider Name (Legal Business Name): H&LL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 E RIVERSONG DR
EAGLE ID
83616-5568
US

IV. Provider business mailing address

1233 E RIVERSONG DR
EAGLE ID
83616-5568
US

V. Phone/Fax

Practice location:
  • Phone: 909-446-9582
  • Fax:
Mailing address:
  • Phone: 909-446-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: HAILEY LOPEZ
Title or Position: OWNER
Credential:
Phone: 909-446-9582