Healthcare Provider Details
I. General information
NPI: 1811211170
Provider Name (Legal Business Name): HOPCO HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/16/2010
Last Update Date: 03/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2257 WILDWOOD AVE
JACKSON MI
49202-3945
US
IV. Provider business mailing address
2257 WILDWOOD AVE
JACKSON MI
49202-3945
US
V. Phone/Fax
- Phone: 517-782-4185
- Fax: 517-782-0130
- Phone: 517-782-4185
- Fax: 517-782-0130
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | 1601000452 |
| License Number State | MI |
VIII. Authorized Official
Name:
SHERYL
LYNN
HOPKINS
Title or Position: OWNER
Credential: M.A.CCC-A
Phone: 517-782-4185