Healthcare Provider Details

I. General information

NPI: 1871771774
Provider Name (Legal Business Name): SMITH HEARING TECHNOLOGIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 W MAIN ST
DECATUR IL
62523-1215
US

IV. Provider business mailing address

252 W MAIN ST
DECATUR IL
62523-1215
US

V. Phone/Fax

Practice location:
  • Phone: 217-422-6042
  • Fax: 217-233-0095
Mailing address:
  • Phone: 217-422-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1950
License Number StateIL

VIII. Authorized Official

Name: MR. THOMAS SCOTT SMITH
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 217-422-6042