Healthcare Provider Details

I. General information

NPI: 1568658326
Provider Name (Legal Business Name): RENAISSANCE HEARING CTRS., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 5TH ST NW
BEMIDJI MN
56601-2915
US

IV. Provider business mailing address

612 5TH ST NW
BEMIDJI MN
56601-2915
US

V. Phone/Fax

Practice location:
  • Phone: 218-444-4444
  • Fax: 218-444-5103
Mailing address:
  • Phone: 218-444-4444
  • Fax: 218-444-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY LAWTON OJA
Title or Position: OWNER
Credential: M.S.
Phone: 218-444-4444