Healthcare Provider Details

I. General information

NPI: 1144573965
Provider Name (Legal Business Name): PREMIER HEARING AND BALANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16038 DOCTORS BLVD
HAMMOND LA
70403-1478
US

IV. Provider business mailing address

16038 DOCTORS BLVD
HAMMOND LA
70403-1478
US

V. Phone/Fax

Practice location:
  • Phone: 985-419-8080
  • Fax: 985-542-0282
Mailing address:
  • Phone: 985-419-8080
  • Fax: 985-542-0282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY L MILLER
Title or Position: OWNER/AUDIOLOGIST
Credential: PH.D. CCC-A
Phone: 985-419-8080