Healthcare Provider Details

I. General information

NPI: 1285099861
Provider Name (Legal Business Name): HORIZON HEARING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S 25TH ST
BETHANY MO
64424-2611
US

IV. Provider business mailing address

1101 S 25TH ST P.O. BOX 503
BETHANY MO
64424-2611
US

V. Phone/Fax

Practice location:
  • Phone: 660-425-7400
  • Fax: 660-425-7404
Mailing address:
  • Phone: 660-425-7400
  • Fax: 660-425-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHG01305
License Number StateMO

VIII. Authorized Official

Name: MRS. ALISHA MICHELLE PURDUN
Title or Position: BUSINESS MANAGER
Credential:
Phone: 660-425-7400