Healthcare Provider Details

I. General information

NPI: 1215356696
Provider Name (Legal Business Name): CIMARRON HEARING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 E MAIN ST
CUSHING OK
74023-2742
US

IV. Provider business mailing address

827 E MAIN ST
CUSHING OK
74023-2742
US

V. Phone/Fax

Practice location:
  • Phone: 918-225-0364
  • Fax: 918-225-2900
Mailing address:
  • Phone: 918-225-0364
  • Fax: 918-225-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: BARBARA ROLLINS
Title or Position: OWNER
Credential: HIS
Phone: 918-225-0364