Healthcare Provider Details

I. General information

NPI: 1306199708
Provider Name (Legal Business Name): SUPREME COMFORT HEARING AID CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MAIN ST STE 8
WESTBROOK ME
04092-4786
US

IV. Provider business mailing address

11 MAIN ST STE 8
WESTBROOK ME
04092-4786
US

V. Phone/Fax

Practice location:
  • Phone: 207-591-4136
  • Fax:
Mailing address:
  • Phone: 207-591-4136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE KUCZEWSKI
Title or Position: OWNER
Credential:
Phone: 207-591-4136