Healthcare Provider Details

I. General information

NPI: 1255646246
Provider Name (Legal Business Name): GRANT'S HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 GREEN ACRES RD SUITE NO. 8
EUGENE OR
97408-1765
US

IV. Provider business mailing address

1020 GREEN ACRES RD SUITE NO. 8
EUGENE OR
97408-1765
US

V. Phone/Fax

Practice location:
  • Phone: 541-344-4442
  • Fax: 541-344-4501
Mailing address:
  • Phone: 541-344-4442
  • Fax: 541-344-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberHAS-P-428163
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. GRANT GORDING
Title or Position: PRESIDENT, CEO
Credential: BC-HIS
Phone: 541-344-4442