Healthcare Provider Details

I. General information

NPI: 1144836800
Provider Name (Legal Business Name): ALLIANCE HEARING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W HIGHWAY 50
O FALLON IL
62269-1618
US

IV. Provider business mailing address

615 N MAIN ST
O FALLON IL
62269-3704
US

V. Phone/Fax

Practice location:
  • Phone: 618-624-4471
  • Fax: 618-624-4496
Mailing address:
  • Phone: 618-215-2169
  • Fax: 618-624-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: CARMEN S ERNST
Title or Position: INSURANCE SPECIALIST
Credential:
Phone: 618-215-2169