Healthcare Provider Details

I. General information

NPI: 1336338672
Provider Name (Legal Business Name): EARCARE OF MCPHERSON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 S MAIN ST
MCPHERSON KS
67460-4843
US

IV. Provider business mailing address

213 S MAIN ST
MCPHERSON KS
67460-4843
US

V. Phone/Fax

Practice location:
  • Phone: 620-504-6313
  • Fax: 620-504-6315
Mailing address:
  • Phone: 620-504-6313
  • Fax: 620-504-6315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number1354
License Number StateKS

VIII. Authorized Official

Name: TIM BRECHEISEN
Title or Position: FOUNDER
Credential:
Phone: 620-504-6313