Healthcare Provider Details

I. General information

NPI: 1245552223
Provider Name (Legal Business Name): COMPREHENSIVE HEARING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4055 CASCADE RD SE STE 201
GRAND RAPIDS MI
49546-2149
US

IV. Provider business mailing address

4055 CASCADE RD SE STE 201
GRAND RAPIDS MI
49546-2149
US

V. Phone/Fax

Practice location:
  • Phone: 616-252-5745
  • Fax: 616-252-5765
Mailing address:
  • Phone: 616-252-5745
  • Fax: 616-252-5765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1601000307
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number1601000307
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000307
License Number StateMI

VIII. Authorized Official

Name: MRS. SHARON KAY HICKOX
Title or Position: MEMBER/OWNER
Credential: AUD, MA, CCC-A
Phone: 616-252-5745