Healthcare Provider Details

I. General information

NPI: 1770868036
Provider Name (Legal Business Name): MODERN HEARING SOLUTIONS OF CANTON INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4072 MUNSON ST. NW
CANTON OH
44718
US

IV. Provider business mailing address

4072 MUNSON ST. NW
CANTON OH
44718
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-3400
  • Fax: 330-493-3403
Mailing address:
  • Phone: 330-493-3400
  • Fax: 330-493-3403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number02190
License Number StateOH

VIII. Authorized Official

Name: ERIC A MOUNTS
Title or Position: MEMBER
Credential: LHIS
Phone: 330-493-3400