Healthcare Provider Details
I. General information
NPI: 1518044668
Provider Name (Legal Business Name): EARCARE OF HUTCHINSON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2534 N MAIN ST
HUTCHINSON KS
67502-3641
US
IV. Provider business mailing address
2534 N MAIN ST
HUTCHINSON KS
67502-3641
US
V. Phone/Fax
- Phone: 620-665-8835
- Fax: 620-665-6252
- Phone: 620-665-8835
- Fax: 620-665-6252
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | 7429 |
| License Number State | KS |
VIII. Authorized Official
Name:
TIM
BRECHEISEN
Title or Position: OWNER
Credential:
Phone: 620-665-8835