Healthcare Provider Details

I. General information

NPI: 1336515683
Provider Name (Legal Business Name): HEAR ON EARTH HEARING CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N TELSHOR BLVD
LAS CRUCES NM
88011-8277
US

IV. Provider business mailing address

920 N TELSHOR BLVD
LAS CRUCES NM
88011-8277
US

V. Phone/Fax

Practice location:
  • Phone: 575-526-3277
  • Fax: 575-522-0026
Mailing address:
  • Phone: 575-526-3277
  • Fax: 575-522-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number0632
License Number StateNM

VIII. Authorized Official

Name: MR. TIMOTHY J JOHNSON
Title or Position: OWNER/SPECIALISTS
Credential: BC HIS
Phone: 575-526-3277