Healthcare Provider Details

I. General information

NPI: 1154042844
Provider Name (Legal Business Name): CHARLIE BROWN HEARING AIDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHESTERFIELD BUSINESS PKWY STE 200
CHESTERFIELD MO
63005-1271
US

IV. Provider business mailing address

3012 FLAMINGO DR
SAINT CHARLES MO
63301-1244
US

V. Phone/Fax

Practice location:
  • Phone: 314-221-3797
  • Fax:
Mailing address:
  • Phone: 636-578-8368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CHARLES BRUCE BROWN
Title or Position: OWNER
Credential: BC-HIS
Phone: 636-578-8368