Healthcare Provider Details

I. General information

NPI: 1255685616
Provider Name (Legal Business Name): BARRE OPTICIANS AND HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 MAIN STREET SOUTH
BARRE PLAINS MA
01005
US

IV. Provider business mailing address

PO BOX 78
SOUTH BARRE MA
01074-0078
US

V. Phone/Fax

Practice location:
  • Phone: 978-355-2191
  • Fax: 978-355-2020
Mailing address:
  • Phone: 978-355-2191
  • Fax: 978-355-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number0034
License Number StateMA

VIII. Authorized Official

Name: MR. SALVATORE N IMPERATO
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential:
Phone: 978-355-2191