Healthcare Provider Details

I. General information

NPI: 1689751018
Provider Name (Legal Business Name): CENTRAL STATE HEARING AID CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S HYDRAULIC ST
WICHITA KS
67211-1908
US

IV. Provider business mailing address

303 S HYDRAULIC ST
WICHITA KS
67211-1908
US

V. Phone/Fax

Practice location:
  • Phone: 316-269-4327
  • Fax: 316-262-4327
Mailing address:
  • Phone: 316-269-4327
  • Fax: 316-262-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberCE569
License Number StateKS

VIII. Authorized Official

Name: TIM BRECHEISEN
Title or Position: OWNER
Credential:
Phone: 316-269-4327