Healthcare Provider Details

I. General information

NPI: 1821274929
Provider Name (Legal Business Name): HEARING CRAFTERS OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 E MT VERNON BLVD
MT VERNON MO
65712
US

IV. Provider business mailing address

708 E MT VERNON BLVD PO BOX 269
MT VERNON MO
65712
US

V. Phone/Fax

Practice location:
  • Phone: 417-466-4245
  • Fax: 417-466-4085
Mailing address:
  • Phone: 417-466-4245
  • Fax: 417-466-4085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateMO

VIII. Authorized Official

Name: MR. SHELL CLAYBROOK
Title or Position: PRESIDENT
Credential:
Phone: 417-466-4245